Provider Demographics
NPI:1265705644
Name:MATHEWS, JEFFREY W (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:W
Last Name:MATHEWS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 CONFERENCE DR STE 5
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-1924
Mailing Address - Country:US
Mailing Address - Phone:615-855-0087
Mailing Address - Fax:615-855-0078
Practice Address - Street 1:919 CONFERENCE DR STE 5
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-1924
Practice Address - Country:US
Practice Address - Phone:615-855-0087
Practice Address - Fax:615-855-0078
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-16
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0000009294122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist