Provider Demographics
NPI:1629752381
Name:HALL, ARIELLE KELLEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARIELLE
Middle Name:KELLEY
Last Name:HALL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MRS
Other - First Name:ARIELLE
Other - Middle Name:KELLEY
Other - Last Name:BUCKNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9449 DAYTON PIKE APT 327
Mailing Address - Street 2:
Mailing Address - City:SODDY DAISY
Mailing Address - State:TN
Mailing Address - Zip Code:37379-4784
Mailing Address - Country:US
Mailing Address - Phone:931-881-6067
Mailing Address - Fax:
Practice Address - Street 1:1272 MARKET ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TN
Practice Address - Zip Code:37321-1250
Practice Address - Country:US
Practice Address - Phone:423-834-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-13
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12241122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist