Provider Demographics
NPI:1811952666
Name:NEWBERRY, PATRICIA J (DDS)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:J
Last Name:NEWBERRY
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 1:3038 NOLENSVILLE ROAD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211
Mailing Address - Country:US
Mailing Address - Phone:615-331-2483
Mailing Address - Fax:615-834-7179
Practice Address - Street 1:3038 NOLENSVILLE ROAD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211
Practice Address - Country:US
Practice Address - Phone:615-331-2483
Practice Address - Fax:615-834-7179
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-17
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6845122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3225885Medicaid
TN148354OtherBCBS