Provider Demographics
NPI:1134340219
Name:MATHENY, HARVEY E (DDS,MSD)
Entity type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:E
Last Name:MATHENY
Suffix:
Gender:M
Credentials:DDS,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7865 EDUCATORS LN
Mailing Address - Street 2:STE. #120
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38133-8191
Mailing Address - Country:US
Mailing Address - Phone:901-380-7994
Mailing Address - Fax:901-380-7995
Practice Address - Street 1:7865 EDUCATORS LN
Practice Address - Street 2:STE. #120
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38133-8191
Practice Address - Country:US
Practice Address - Phone:901-380-7994
Practice Address - Fax:901-380-7995
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN24781223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics