Provider Demographics
NPI:1477298719
Name:DIXON, KRISTIN GRIFFIN
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:GRIFFIN
Last Name:DIXON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 STURDIVANT RD
Mailing Address - Street 2:
Mailing Address - City:BURLISON
Mailing Address - State:TN
Mailing Address - Zip Code:38015-7229
Mailing Address - Country:US
Mailing Address - Phone:901-568-2377
Mailing Address - Fax:
Practice Address - Street 1:8020 US HIGHWAY 51 N
Practice Address - Street 2:
Practice Address - City:MILLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38053-1732
Practice Address - Country:US
Practice Address - Phone:901-872-3391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6967124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist