Provider Demographics
NPI:1164547139
Name:JEAN-PIERRE, JEAN-MAX (DDS MDS)
Entity Type:Individual
Prefix:DR
First Name:JEAN-MAX
Middle Name:
Last Name:JEAN-PIERRE
Suffix:
Gender:M
Credentials:DDS MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1779 KIRBY PKWY # 14716
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3666
Mailing Address - Country:US
Mailing Address - Phone:629-777-6455
Mailing Address - Fax:
Practice Address - Street 1:100 SPRINGHOUSE CT.
Practice Address - Street 2:SUITE 220
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075
Practice Address - Country:US
Practice Address - Phone:615-264-6404
Practice Address - Fax:615-264-0689
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000081671223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics