Devin Kye Krekel, D.M.D

Individual provider Active NPI General Practice Dentistry · Fairview, TN

NPI 1457790396 · NPPES record last updated Jul 22, 2020

Key facts

NPI
1457790396
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
9996 (TN)
Practice address
7022 City Center Way
Fairview, TN 37062-6004
Phone
(615) 266-2645
NPI assigned
Jun 24, 2013
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
9996TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Provision Family Dental, PLLC D/B/a Fairview Family Dentistry General Practice Past
since Aug 2, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9996 TN Yes

Addresses

Primary practice location

7022 City Center Way
Fairview, TN 37062-6004

Mailing address

7022 City Center Way
Fairview, TN 37062-6004
Phone (615) 266-2645

Other providers in Fairview, TN

All providers in Fairview, TN · General Practice Dentistry in Tennessee

Sources for this page

Verify at the official NPI Registry.