Provider Demographics
NPI:1306854310
Name:DEAN, DONNIE K (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONNIE
Middle Name:K
Last Name:DEAN
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 1:121 CAPITAL DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3393
Mailing Address - Country:US
Mailing Address - Phone:865-539-1119
Mailing Address - Fax:865-539-9833
Practice Address - Street 1:121 CAPITAL DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3393
Practice Address - Country:US
Practice Address - Phone:865-539-1119
Practice Address - Fax:865-539-9833
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5216122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0134304OtherBCBS