Provider Demographics
NPI:1952909350
Name:ATES, BRANDIE WHITE (DMD)
Entity type:Individual
Prefix:DR
First Name:BRANDIE
Middle Name:WHITE
Last Name:ATES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:BRANDIE
Other - Middle Name:LYNN
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:PO BOX 366
Mailing Address - Street 2:
Mailing Address - City:WHITE HOUSE
Mailing Address - State:TN
Mailing Address - Zip Code:37188
Mailing Address - Country:US
Mailing Address - Phone:615-672-3774
Mailing Address - Fax:615-672-9630
Practice Address - Street 1:2899 HWY 31W SOUTH
Practice Address - Street 2:
Practice Address - City:WHITE HOUSE
Practice Address - State:TN
Practice Address - Zip Code:37188
Practice Address - Country:US
Practice Address - Phone:615-672-3774
Practice Address - Fax:615-672-9630
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-16
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN114031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN11403OtherDENTAL LICENSE