Provider Demographics
NPI:1508208216
Name:HUMPHREYS, SARAH (DMD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:HUMPHREYS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 TOLLGATE BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:THOMPSONS STATION
Mailing Address - State:TN
Mailing Address - Zip Code:37179-1005
Mailing Address - Country:US
Mailing Address - Phone:615-656-0854
Mailing Address - Fax:
Practice Address - Street 1:2000 TOLLGATE BLVD STE 205
Practice Address - Street 2:
Practice Address - City:THOMPSONS STATION
Practice Address - State:TN
Practice Address - Zip Code:37179-1005
Practice Address - Country:US
Practice Address - Phone:615-560-3585
Practice Address - Fax:615-813-6712
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9673122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist