Provider Demographics
NPI:1568876134
Name:JARRELL, TAYLOR JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:JAMES
Last Name:JARRELL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MS
Other - First Name:TAYLOR
Other - Middle Name:KATELYN
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:632 SMITHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37803-6100
Mailing Address - Country:US
Mailing Address - Phone:865-977-8877
Mailing Address - Fax:
Practice Address - Street 1:632 SMITHVIEW DR
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37803-6100
Practice Address - Country:US
Practice Address - Phone:865-977-8877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-11
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9854122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist