Provider Demographics
NPI:1942828124
Name:ADKINS FAMILY DENTISTRY, PLLC
Entity Type:Organization
Organization Name:ADKINS FAMILY DENTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DONNIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:423-638-5141
Mailing Address - Street 1:600 TUSCULUM BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-3954
Mailing Address - Country:US
Mailing Address - Phone:423-638-5141
Mailing Address - Fax:423-638-5131
Practice Address - Street 1:600 TUSCULUM BLVD STE 1
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-3954
Practice Address - Country:US
Practice Address - Phone:423-638-5141
Practice Address - Fax:423-638-5131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN151881Medicaid