Provider Demographics
NPI:1487531679
Name:VESCOVO FAMILY DENTISTRY
Entity type:Organization
Organization Name:VESCOVO FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:VESCOVO
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:901-867-9900
Mailing Address - Street 1:5733 AIRLINE RD # 101
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-5133
Mailing Address - Country:US
Mailing Address - Phone:901-867-9900
Mailing Address - Fax:901-317-7685
Practice Address - Street 1:5733 AIRLINE RD # 101
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38002-5133
Practice Address - Country:US
Practice Address - Phone:901-867-9900
Practice Address - Fax:901-317-7685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty