PROVENCE AND HALEY, PC (NPI# 1225263460) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225263460 |
| Entity Type | Organization |
| Organization Name | PROVENCE AND HALEY, PC |
| Other Organization Name | TENNESSEE ORAL & MAXILLOFACIAL SURGEONS |
| Practice Address |
4322 Harding Pike Suite 201 Nashville TN 37205-2490 |
| Practice Telephone | 6158297000 |
| Practice Fax Number | 6158297001 |
| Mailing Telephone | 6158297000 |
| Mailing Fax Number | 6158297001 |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2009-05-18 |
| Authorized Official Name | MR. MINA H HARRIS (OFFICE MANAGER) |
| Authorized Official Telephone | 6154191943 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DS4607 | TN | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DS7219 | TN | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BCBST | 2006315 | 01 |
| UNITED CONCORDIA | 667954 | 01 | |
| TN | DENTAL LICENSE | 7219 | 01 |
| UNITED CONCORDIA | 918666 | 01 | |
| TN | DENTAL LICENSE | 4607 | 01 |
| TN | BCBST | 3141185 | 01 |
| NPI | 1275531972 | 01 | |
| NPI | 1982601829 | 01 |
| Other Name | Type Code |
|---|---|
| Tennessee Oral & Maxillofacial Surgeons | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033344288 | Provence and Haley, PC | Dentist | 502 E College St, Dickson, TN 37055-2016 | 2009-05-18 |
| Street Address |
4322 HARDING PIKE SUITE 201 |
| City | NASHVILLE |
| State | TN |
| Zip Code | 37205-2490 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396738720 | Politzer and Durocher Plc | Optometrist | 4322 Harding Pike, Suite 214, Nashville, TN 37205-2490 | 2005-08-31 |
| 1760938096 | William Gene Parsley IIi | Optometrist | 4322 Harding Pike, Suite 214, Nashville, TN 37205-2654 | 2016-08-28 |
| 1093115156 | Lisa Battle-gwathney | Psychologist | 4322 Harding Pike, Ste 417, Nashville, TN 37205-2664 | 2014-08-26 |
| 1780817221 | Susanna C Trabue | Nurse Practitioner | 4322 Harding Pike, Suite 329, Nashville, TN 37205-2490 | 2009-09-01 |
| 1720251374 | Heather Michelle Barrow | Pediatrics | 4322 Harding Pike, Suite 229, Nashville, TN 37205-2490 | 2008-04-03 |
| 1194940056 | Kimberly Ann Buie | Pediatrics | 4322 Harding Pike, Suite 229, Nashville, TN 37205-2490 | 2007-04-16 |
| 1154453884 | Woods Gynecology, PC | Specialist | 4322 Harding Pike, Suite 329, Nashville, TN 37205-2490 | 2007-03-09 |
| 1851422349 | Green Hills Pediatric Associates | Pediatrics | 4322 Harding Pike, Suite 229, Nashville, TN 37205-2490 | 2007-03-08 |
| 1396893921 | Donald W Griffin | Plastic Surgery | 4322 Harding Pike, Ste 314, Nashville, TN 37205-2490 | 2007-01-08 |
| 1972669133 | Elizabeth Grimes Triggs | Pediatrics | 4322 Harding Pike, Suite 229, Nashville, TN 37205-2490 | 2006-12-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316548191 | Anne Nicole Koethe | Nurse Practitioner | Saint Thomas Medical Group, 4230 Harding Pike #503, Nashville, TN 37205 | 2020-11-06 |
| 1396307260 | Tyler G Smith | Dentist | 104 Kenner Ave., Suite #101, Nashville, TN 37205 | 2019-07-01 |
| 1487129508 | The Counseling Center At Belle Meade United Methodist Church, LLC | Counselor | Counseling Center At Belle Meade Umc, 121 Davidson Road, Nashville, TN 37205 | 2018-10-04 |
| 1932592953 | Generations Behavioral Health LLC | Psychiatric Hospital | 4423 Forsythe Place, Nashville, TN 37205 | 2015-03-16 |
| 1114323284 | Caroline Rhett Hartman | Counselor | 85 White Bridge Road, Ste 302, Nashville, TN 37205 | 2014-11-17 |
| 1619316387 | Sarah Jane Grayce | Psychiatry & Neurology | 85 White Bridge Rd Ste 302, Nashville, TN 37205 | 2013-06-17 |
| 1902142920 | Smita K Rao | Genetic Counselor, MS | 4220 Harding Pike Ste 200, Nashville, TN 37205 | 2012-12-19 |
| 1225386154 | Jessica Blain Trumble | Registered Nurse | 204 Carden Ave, Nashville, TN 37205 | 2012-08-27 |
| 1962778167 | Bryan Richard Hay | Internal Medicine | 4320 Harding Pike Ste 503, Nashville, TN 37205 | 2012-04-02 |
| 1184998064 | Christopher Snider | Specialist/Technologist, Other | 738 Templeton Dr, Nashville, TN 37205 | 2012-02-24 |
| Find all providers in zip 37205 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396199055 | Daniel Coke | Dentist | 1301 Medical Center Dr # 1601, Nashville, TN 37232-0028 | 2016-04-19 |
| 1073910725 | Nashville Oral Facial Surgery, Pllc | Dentist | 2400 Patterson St Ste 316, Nashville, TN 37203-6510 | 2014-11-24 |
| 1013200054 | Ryan Fitzgerald Thomas | Dentist | 5802 Nolensville Pike Ste 103, Nashville, TN 37211-6540 | 2011-05-24 |
| 1497084057 | Kendall M Sims | Dentist | 1829 Jo Johnston Ave, Nashville, TN 37203-2870 | 2009-12-10 |
| 1013100551 | Matthew Mizukawa | Dentist | 1623 The Vanderbilt Clinic, Nashville, TN 37232-0001 | 2007-08-18 |
| 1770606014 | Cooper Oral & Maxillofacial Surgery, PC | Dentist | 207 Twenty Third Avenue North, Nashville, TN 37203-1501 | 2007-04-10 |
| 1447317953 | Robin Ricardo Daniel | Dentist | 1829 Jo Johnston Avenue, Nashville, TN 37203-2120 | 2007-01-03 |
| 1598830770 | Christian Clarence Bennerman | Dentist | 2653 Lakevilla Dr, Nashville, TN 37217-3836 | 2006-11-22 |
| 1477635324 | Oral & Facial Surgery Group PC | Dentist | 300 20th Ave N Ste 606, Nashville, TN 37203-5606 | 2006-10-19 |
| 1639263783 | Harry Russell Mack Jr. | Dentist | 5802 Nolensville Pike, Suite #103, Nashville, TN 37211-6520 | 2006-10-03 |
| Find all providers in NASHVILLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.