Provider Demographics
NPI:1801942594
Name:STONE, KELLEE (DDS)
Entity type:Individual
Prefix:DR
First Name:KELLEE
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 BELL RD
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-3730
Mailing Address - Country:US
Mailing Address - Phone:615-717-0507
Mailing Address - Fax:615-717-0507
Practice Address - Street 1:1315 BELL RD
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-3730
Practice Address - Country:US
Practice Address - Phone:615-717-0507
Practice Address - Fax:615-717-0507
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8180122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN9177139Medicare ID - Type Unspecified