PROVENCE AND HALEY, PC (NPI# 1033344288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033344288 |
| Entity Type | Organization |
| Organization Name | PROVENCE AND HALEY, PC |
| Other Organization Name | TENNESSEE ORAL & MAXILLOFACIAL SURGEONS |
| Practice Address |
502 E College St Dickson TN 37055-2016 |
| Mailing Address |
4322 Harding Pike Suite 201 Nashville TN 37205-2490 |
| Practice Telephone | 6154469669 |
| Practice Fax Number | 6154469661 |
| Mailing Telephone | 6158297000 |
| Mailing Fax Number | 6158297001 |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2009-05-18 |
| Authorized Official Name | MRS. 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 |
DS7219 | TN | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DS4607 | TN | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | DENTAL LICENSE | 7219 | 01 |
| TN | UNITED CONCORDIA | 918666 | 01 |
| TN | BCBST | 3141185 | 01 |
| UNITED CONCORDIA | 667954 | 01 | |
| NPI | 1275531972 | 01 | |
| NPI | 1982601829 | 01 | |
| TN | DENTAL LICENSE | 4607 | 01 |
| TN | BCBST | 2006315 | 01 |
| Other Name | Type Code |
|---|---|
| Tennessee Oral & Maxillofacial Surgeons | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225263460 | Provence and Haley, PC | Dentist | 4322 Harding Pike, Suite 201, Nashville, TN 37205-2490 | 2009-05-18 |
| Street Address |
502 E COLLEGE ST |
| City | DICKSON |
| State | TN |
| Zip Code | 37055-2016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801406186 | Raven Julia Jackson | Dentist | 445 Tn-46 S, Dickson, TN 37055 | 2020-08-03 |
| 1336767839 | Logan Newman | Student in an Organized Health Care Education/Training Program | 102 Us70 East, Suite 2, Dickson, TN 37055 | 2020-07-10 |
| 1720575012 | Vb Tennessee I Pllc | Dentist | 2027 Thornton Dr, Dickson, TX 37055 | 2018-04-23 |
| 1376075358 | Sharon Elizabeth Sharber | Nurse Practitioner | 111 Highway 70 E Ste E, Dickson, TN 37055 | 2017-03-29 |
| 1992255921 | Karen Alonzo | Occupational Therapy Assistant | 312 N Charlotte St, Dickson, TN 37055 | 2016-10-13 |
| 1356727408 | Aurora Pharmacy Inc | Pharmacy | 318 East College Street, Suite 102, Dickson, TN 37055 | 2015-07-30 |
| 1295121820 | Jeffrey Nicholas Williams | Pharmacy Technician | 120 Brazzell Rd, Dickson, TN 37055 | 2015-04-10 |
| 1760894398 | Joshua A. Vaughn | Physical Therapist | 766 Highway 46 South, Dickson, TN 37055 | 2014-06-02 |
| 1902217292 | Keith Payton | Dentist | 217 Highway 46 Ste D, Dickson, TN 37055 | 2014-05-08 |
| 1073953840 | John Harrison | Dentist | 134 Us-70, Dickson Pediatric Dentistry, Dickson, TN 37055 | 2013-06-26 |
| Find all providers in zip 37055 | ||||
| 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 |
|---|---|---|---|---|
| 1912917238 | Michael S Willis | Dentist | 445 Henslee Drive, Ste B, Dickson, TN 37055 | 2006-08-09 |
| 1639114002 | Truitt Anthony Savell | Dentist | 445 Henslee Dr, Dickson, TN 37055-2166 | 2006-06-18 |
| 1922568666 | Mckenzie Oral and Facial Surgery Pllc | Dentist | 445 Henslee Dr, Dickson, TN 37055-2166 | 2019-03-20 |
| 1437585346 | Mid-state Oral Surgery & Implant Center, PC | Dentist | 445 Henslee Dr, Dickson, TN 37055-2166 | 2013-09-24 |
| 1215032438 | Dickson Jaw & Facial Surgery | Dentist | 445 Henslee Dr, Dickson, TN 37055-2166 | 2006-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396199055 | Daniel Coke | Dentist | 1301 Medical Center Dr # 1601, Nashville, TN 37232-0028 | 2016-04-19 |
| 1467835140 | Amir Victor Francis | Dentist | 1100 Poplar View Ln N Ste 1, Collierville, TN 38017-9323 | 2015-06-30 |
| 1376939645 | Matthew Breit | Dentist | 1251 Wesley Dr Ste 101, Memphis, TN 38116-6442 | 2015-04-13 |
| 1720472855 | Charles Baker Felts Iv | Dentist | 901 Riverfront Pkwy Ste 202, Chattanooga, TN 37402-2193 | 2015-03-26 |
| 1073910725 | Nashville Oral Facial Surgery, Pllc | Dentist | 2400 Patterson St Ste 316, Nashville, TN 37203-6510 | 2014-11-24 |
| 1194122135 | Samuel Edward Molind | Dentist | 210 Memorial Dr, Bristol, TN 37620-1704 | 2014-11-19 |
| 1780094052 | Andrew Ferraro | Dentist | 2964 Miller Place Way, Knoxville, TN 37924-1673 | 2014-05-07 |
| 1144649393 | Thomas Bailey | Dentist | 3000 Stansberry Ln Ste 101, Franklin, TN 37069-5125 | 2014-04-15 |
| 1376962613 | John Christopher Swearingen | Dentist | 780 Ridge Lake Blvd Ste 101, Memphis, TN 38120 | 2014-04-15 |
| 1427471382 | Oral & Maxillofacial Surgery Clinic Inc. | Dentist | 910 Madison Ave Ste 710, Memphis, TN 38103-3453 | 2014-01-29 |
| Find all providers with the same taxonomy | ||||
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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.