Provider Demographics
NPI:1003329558
Name:ANDREW R. FLIPSE, DMD, PLLC
Entity Type:Organization
Organization Name:ANDREW R. FLIPSE, DMD, PLLC
Other - Org Name:IMPLANT AND GENERAL DENTISTRY OF MIDDLE TENNESSEE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:FLIPSE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:615-893-8771
Mailing Address - Street 1:4170 E JEFFERSON PIKE
Mailing Address - Street 2:
Mailing Address - City:LASCASSAS
Mailing Address - State:TN
Mailing Address - Zip Code:37085-4586
Mailing Address - Country:US
Mailing Address - Phone:615-605-6865
Mailing Address - Fax:
Practice Address - Street 1:1110 W CLARK BLVD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2340
Practice Address - Country:US
Practice Address - Phone:615-893-8771
Practice Address - Fax:615-893-8781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN101341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1457729774OtherNPI NUMBER NON-CONTRACTED
1679691922OtherNPI NUMBER NON-CONTRACTED