CHILDRENS DENTISTRY OF MURFREESBORO PLLC (NPI# 1548463466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548463466 |
| Entity Type | Organization |
| Organization Name | CHILDRENS DENTISTRY OF MURFREESBORO PLLC |
| Practice Address |
538 Brandies Circle Suite 102 Murfreesboro TN 37128 |
| Mailing Address |
Po Box 331362 Murfreesboro TN 37133-1362 |
| Practice Telephone | 9014843812 |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JACK DANIEL MALLETTE (OWNER-PROVIDER) |
| Authorized Official Telephone | 9014843812 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DS8406 | TN | Dental Providers |
| Street Address |
538 BRANDIES CIRCLE SUITE 102 |
| City | MURFREESBORO |
| State | TN |
| Zip Code | 37128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932328317 | Jack Daniel Mallette | Dentist | 538 Brandies Circle, Suite 102, Murfreesboro, TN 37128 | 2007-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386196020 | Kayce Gaw | Nurse Practitioner | 4432 Veteran Pkwy, Murfreesburo, TN 37128 | 2016-10-28 |
| 1912459009 | William Alan Brasch | Physical Therapy Assistant | 3209 Grantown Dr, Murfreesboro, TN 37128 | 2016-10-25 |
| 1558811695 | Tennessee Family Solutions, Inc. | Intermediate Care Facility, Mentally Retarded | 722-724 Stone Trace Drive, Murfreesboro, TN 37128 | 2016-10-13 |
| 1225584469 | Mitchel Hubert | Hearing Instrument Specialist | North, 2441 Old Fort Pkwy, Murfreesboro, TN 37128 | 2016-08-28 |
| 1821445776 | Amy Sickman Parsley | Optometrist | Integrity Eye Care, 4144 Franklin Road, Murfreesboro, TN 37128 | 2016-05-20 |
| 1043610561 | Joseph Mark Cotten | Nurse Practitioner | 4058 Franklin Rd, Murfreesboro, TN 37128 | 2014-09-03 |
| 1811313489 | Miriam Ijeoyibo Obioha | Nurse Anesthetist, Certified Registered | 3033 Community Cir, Murfreesboro, TN 37128 | 2014-03-06 |
| 1770924284 | Omni Community Health | Clinic/Center | 545 Brandies Circle, Murfreesboro, TN 37128 | 2013-07-12 |
| 1336400480 | Jokeidre Butler | Dentist | 1141 Fortress Blvd, Ste D., Murfreesboro, TN 37128 | 2012-06-05 |
| 1497012959 | Trustpoint Hospital, LLC | Psychiatric Hospital | 1009 N. Thompson Ln, Murfreesboro, TN 37128 | 2012-04-20 |
| Find all providers in zip 37128 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932328317 | Jack Daniel Mallette | Dentist | 538 Brandies Circle, Suite 102, Murfreesboro, TN 37128 | 2007-04-24 |
| 1477699734 | Stephen Eric Simpson | Dentist | 132 Heritage Park Dr, Suite 3, Murfreesboro, TN 37129-0564 | 2007-01-30 |
| 1487635025 | Jay Chadwick Curry | Dentist | 614 E Clark Blvd, Murfreesboro, TN 37130-2121 | 2005-11-10 |
| 1477061273 | Eric Phan | Dentist | 614 E Clark Blvd, Murfreesboro, TN 37130-2121 | 2018-01-15 |
| 1801329917 | Apc Dentistry | Dentist | 2805 Old Fort Pkwy, Murfreesboro, TN 37128-5115 | 2017-04-05 |
| 1265884357 | Katelyn Olenich Reeves | Dentist | 614 E Clark Blvd, Murfreesboro, TN 37130-2121 | 2016-07-13 |
| 1740600816 | Helen Bono | Dentist | 614 E Clark Blvd, Murfreesboro, TN 37130-2121 | 2014-04-16 |
| 1639386394 | Amy Michelle Roeder | Dentist | 2805 Old Fort Pkwy, Suite A, Murfreesboro, TN 37128-5115 | 2007-05-16 |
| 1316164833 | Joseph A Faiz | Dentist | 2910 Old Fort Pkwy, Murfreesboro, TN 37128-4158 | 2007-04-18 |
| 1669560090 | Jason Ronald Vogt | Dentist | 614 E Clark Blvd, Murfreesboro, TN 37130-2121 | 2006-10-11 |
| Find all providers in MURFREESBORO | ||||
| City | MURFREESBORO |
| Zip Code | 37128 |
Please comment or provide details below to improve the information on CHILDRENS DENTISTRY OF MURFREESBORO PLLC.
| 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.