Provider Demographics
NPI:1699849943
Name:EADES, JOSHUA LYNN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:LYNN
Last Name:EADES
Suffix:
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 1:8323 BAY GARDEN LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37938-4595
Mailing Address - Country:US
Mailing Address - Phone:865-922-5383
Mailing Address - Fax:
Practice Address - Street 1:3001 KNOXVILLE CENTER DR
Practice Address - Street 2:SUITE 1100
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37924-5044
Practice Address - Country:US
Practice Address - Phone:865-544-1711
Practice Address - Fax:865-544-1712
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN82001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice