Provider Demographics
NPI:1528044914
Name:WORTHY, ARTMAS LEROY (DDS)
Entity Type:Individual
Prefix:MR
First Name:ARTMAS
Middle Name:LEROY
Last Name:WORTHY
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 1:1700 DB TODD BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37208
Mailing Address - Country:US
Mailing Address - Phone:615-320-0662
Mailing Address - Fax:615-327-3278
Practice Address - Street 1:1700 DB TODD BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208
Practice Address - Country:US
Practice Address - Phone:615-320-0662
Practice Address - Fax:615-327-3278
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS2873122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN322-0892Medicaid