Provider Demographics
NPI:1407023971
Name:DICKSON PEDIATRIC DENTISTRY PLLC
Entity Type:Organization
Organization Name:DICKSON PEDIATRIC DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CARLOS
Authorized Official - Last Name:STRITIKUS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-740-8812
Mailing Address - Street 1:134 HIGHWAY 70 E UNIT 1
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2034
Mailing Address - Country:US
Mailing Address - Phone:615-740-8812
Mailing Address - Fax:615-740-8801
Practice Address - Street 1:134 HIGHWAY 70 E UNIT 1
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2034
Practice Address - Country:US
Practice Address - Phone:615-740-8812
Practice Address - Fax:615-740-8801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS73801223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty