Provider Demographics
NPI:1255749339
Name:TRIVETTE, OSBORNE & MAYS, PLLC
Entity type:Organization
Organization Name:TRIVETTE, OSBORNE & MAYS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:A
Authorized Official - Last Name:OSBORNE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:865-687-3203
Mailing Address - Street 1:2931 ESSARY DR
Mailing Address - Street 2:SUITE #1
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-2404
Mailing Address - Country:US
Mailing Address - Phone:865-687-3203
Mailing Address - Fax:865-687-3299
Practice Address - Street 1:2931 ESSARY DR
Practice Address - Street 2:SUITE #1
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-2404
Practice Address - Country:US
Practice Address - Phone:865-687-3203
Practice Address - Fax:865-687-3299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-01
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN50281223G0001X
TN51361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty