Provider Demographics
NPI:1013588011
Name:FEHRMAN, KIRKLAND A (DMD)
Entity type:Individual
Prefix:DR
First Name:KIRKLAND
Middle Name:A
Last Name:FEHRMAN
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 1:134 HIGHWAY 70 E
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2034
Mailing Address - Country:US
Mailing Address - Phone:615-740-8812
Mailing Address - Fax:615-740-8801
Practice Address - Street 1:134 HIGHWAY 70 E
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2034
Practice Address - Country:US
Practice Address - Phone:615-740-8812
Practice Address - Fax:615-740-8801
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN124691223P0221X
WI1002674-151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Yes1223P0221XDental ProvidersDentistPediatric Dentistry