Provider Demographics
NPI:1386862035
Name:GILLCRIST, JAMES ALBERT (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ALBERT
Last Name:GILLCRIST
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 1:310 GREAT CIRCLE ROAD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37243
Mailing Address - Country:US
Mailing Address - Phone:615-507-6494
Mailing Address - Fax:615-741-0882
Practice Address - Street 1:310 GREAT CIRCLE ROAD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37243
Practice Address - Country:US
Practice Address - Phone:615-507-6494
Practice Address - Fax:615-741-0882
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS38111223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health