Provider Demographics
NPI:1760985360
Name:GREEN HILLS DENTAL CENTER, PLLC
Entity Type:Organization
Organization Name:GREEN HILLS DENTAL CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:KIRBY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-327-2123
Mailing Address - Street 1:2000 RICHARD JONES RD STE 109
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2885
Mailing Address - Country:US
Mailing Address - Phone:615-327-2123
Mailing Address - Fax:615-327-7973
Practice Address - Street 1:2000 RICHARD JONES RD STE 109
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2885
Practice Address - Country:US
Practice Address - Phone:615-327-2123
Practice Address - Fax:615-327-7973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-10
Last Update Date:2018-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8899261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental