Tesa Harris Jolly, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

8941 Issued in TN

Practice address

217 W Jefferson St
Suite 1
Pulaski, TN 38478-2835

Phone

(931) 363-1564

Fax

(931) 363-1559

NPI assigned

Dec 13, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dr. Tesa H. Jolly

  • General Practice Dentistry
  • Pulaski, TN
  • NPI 1518460500
  NPD (past)

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

{
    "created_epoch": "1229126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520985600000",
    "number": "1891930293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 W JEFFERSON ST",
            "address_2": "SUITE 1",
            "city": "PULASKI",
            "state": "TN",
            "postal_code": "384782835",
            "telephone_number": "931-363-1564",
            "fax_number": "931-363-1559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 W JEFFERSON ST",
            "address_2": "SUITE 1",
            "city": "PULASKI",
            "state": "TN",
            "postal_code": "384782835",
            "telephone_number": "931-363-1564",
            "fax_number": "931-363-1559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLY",
        "first_name": "TESA",
        "middle_name": "HARRIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-13",
        "last_updated": "2018-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "8941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1513043",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Pulaski, TN
• Providers in Pulaski, TN by specialty
• Dentist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.