Provider Demographics
NPI:1659794154
Name:BENITEZ, NANCY ELIZABETH (DA)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ELIZABETH
Last Name:BENITEZ
Suffix:
Gender:F
Credentials:DA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2026 CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1910
Mailing Address - Country:US
Mailing Address - Phone:615-321-5600
Mailing Address - Fax:
Practice Address - Street 1:2026 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1910
Practice Address - Country:US
Practice Address - Phone:615-321-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-04
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDA0000017844126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant