1700875879 NPI number — THOMAS W ONSTOTTDDSPC AND LARRY E FARRIS DDSPC FAMILY DENTISTRY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700875879 NPI number — THOMAS W ONSTOTTDDSPC AND LARRY E FARRIS DDSPC FAMILY DENTISTRY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THOMAS W ONSTOTTDDSPC AND LARRY E FARRIS DDSPC FAMILY DENTISTRY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700875879
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
201 5TH AVE W
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRINGFIELD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37172-2415
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-384-2659
Provider Business Mailing Address Fax Number:
615-384-0672

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 5TH AVE W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37172-2415
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-384-2659
Provider Business Practice Location Address Fax Number:
615-384-0672
Provider Enumeration Date:
10/20/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ONSTOTT
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
WOODROW
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
615-384-2659

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  2943 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com