Provider Demographics
NPI:1790843415
Name:HOUSE, JENNIFER (DMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:HOUSE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 WOODLAWN DRIVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212
Mailing Address - Country:US
Mailing Address - Phone:615-672-7221
Mailing Address - Fax:615-672-7211
Practice Address - Street 1:520 HIGHWAY 76 STE 9
Practice Address - Street 2:
Practice Address - City:WHITE HOUSE
Practice Address - State:TN
Practice Address - Zip Code:37188-8212
Practice Address - Country:US
Practice Address - Phone:615-672-7221
Practice Address - Fax:615-672-7211
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS-85641223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry