Provider Demographics
NPI:1225325640
Name:MCGOWAN, HARI I (DDS)
Entity Type:Individual
Prefix:
First Name:HARI
Middle Name:I
Last Name:MCGOWAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N WOODS CT
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7800
Mailing Address - Country:US
Mailing Address - Phone:615-364-2037
Mailing Address - Fax:
Practice Address - Street 1:95 SEABOARD LN STE 102
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-3037
Practice Address - Country:US
Practice Address - Phone:615-377-3080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN000000000000122300000X
TN95541223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist