JAMES T. DEBERRY, JR., DDS, MS, PC - NPI 1194147421

Q: What is the provider's specialty?

The provider's specialty is Dentist with taxonomy code 1223P0221X and a focus in Pediatric Dentistry.

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About James T. Deberry, Jr., Dds, Ms, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAMES T. DEBERRY, JR., DDS, MS, PC (NPI 1194147421) is a healthcare organization registered as a pediatric dentistry in Knoxville, Tennessee and active in the NPI registry since January 2014. The organization lists James T Deberry, Owner, as its authorized official.

NPPES Registry Identity

NPI1194147421

Entity TypeOrganization

Primary Taxonomy1223P0221X

Legal Business NameJAMES T. DEBERRY, JR., DDS, MS, PC

Location Address10261 KINGSTON PIKEKnoxville, TN 37922-3276

Mailing Address10261 Kingston PikeKnoxville, TN 37922-3276 · (865) 691-1404 · Fax (865) 691-0836

Phone(865) 691-1404

Fax(865) 691-0836

Organization SubpartNo

Authorized OfficialJames T DeberryOwner · (865) 691-1404

Enumeration DateJanuary 6, 2014

✔ NPI 1194147421 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers

Taxonomy Code1223P0221X

License✔ Licensed in TN · DS2089

Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

10261 KINGSTON PIKE, Knoxville, TN 37922

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Other Identifiers 1

Medicaid1225279359TN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP