Provider Demographics
NPI:1043259906
Name:READ, DANIEL S (DMD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:S
Last Name:READ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:DANIEL
Other - Middle Name:S
Other - Last Name:READ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:111 FOX RD STE 201
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3304
Mailing Address - Country:US
Mailing Address - Phone:865-291-1520
Mailing Address - Fax:865-291-1521
Practice Address - Street 1:111 FOX RD STE 201
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3304
Practice Address - Country:US
Practice Address - Phone:865-291-1520
Practice Address - Fax:865-291-1521
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN73941223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNU42131Medicare UPIN