Provider Demographics
NPI:1689989451
Name:FLEENOR, JAMES RALPH III (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RALPH
Last Name:FLEENOR
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 MONROE PL STE 104
Mailing Address - Street 2:
Mailing Address - City:ASHLAND CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37015-4940
Mailing Address - Country:US
Mailing Address - Phone:615-235-5144
Mailing Address - Fax:
Practice Address - Street 1:189 MONROE PL STE 104
Practice Address - Street 2:
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015-4940
Practice Address - Country:US
Practice Address - Phone:615-235-5144
Practice Address - Fax:615-645-2337
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-17
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY8823122300000X
IN12011376A122300000X
TN94011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist