Provider Demographics
NPI:1831233246
Name:STEVEN F. THAXTON, DDS, PA
Entity type:Organization
Organization Name:STEVEN F. THAXTON, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:FRANKLIN
Authorized Official - Last Name:THAXTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-444-3185
Mailing Address - Street 1:312 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-3546
Mailing Address - Country:US
Mailing Address - Phone:615-444-3185
Mailing Address - Fax:
Practice Address - Street 1:312 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-3546
Practice Address - Country:US
Practice Address - Phone:615-444-3185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000029391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty