Veran Antonita Fairrow, DDS, MPH
Individual provider Active NPI Dentist · Woodlawn, TN
NPI 1386758241 · NPPES record last updated Jul 24, 2024
Key facts
- NPI
- 1386758241
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DS0000005248 (TN)
- Practice address
- 2245 York Rd
Woodlawn, TN 37191-9159 - Phone
- (615) 772-3267
- NPI assigned
- Aug 18, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11218 | KY | MD | Dentist |
| DS0000005248 | TN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Donald a Jones DDS | Past |
Accepting new patients | |
| Dental Sleep Solutions of Clarksville LLC | Dentist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 11218 | KY | |
| Dentist | 122300000X | DS0000005248 | TN | Yes |
Addresses
Primary practice location
2245 York Rd
Woodlawn, TN 37191-9159
Mailing address
2245 York Rd
Woodlawn, TN 37191-9159
Phone (615) 772-3267
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3202696 | Medicaid | TN |
Other providers in Woodlawn, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.