West Tennessee Dentistry PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7557 Issued in TN

Legal business name

WEST TENNESSEE DENTISTRY PLLC

Doing business as

Dove Family Dentistry

Practice address

1108 Whitehall St
Jackson, TN 38301-3730

Phone

(972) 869-3789

NPI assigned

Apr 17, 2018

Last updated

Apr 17, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Faith Gaskins

Title

Director of Credentialing

Phone

(972) 869-3789

Specialties & licenses 1

Addresses

Other names 1

• Dove Family Dentistry Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523923200000",
    "number": "1407343254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2403 LACY LN",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750066514",
            "telephone_number": "972-869-3789",
            "fax_number": "972-590-8809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 WHITEHALL ST",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013730",
            "telephone_number": "972-869-3789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST TENNESSEE DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-17",
        "last_updated": "2018-04-17",
        "status": "A",
        "authorized_official_last_name": "GASKINS",
        "authorized_official_first_name": "FAITH",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "7557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dove Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Jackson, TN
• Providers in Jackson, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.