Provider Demographics
NPI: | 1093179970 |
---|---|
Name: | GENX INVESTMENTS LLC |
Entity type: | Organization |
Organization Name: | GENX INVESTMENTS LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | STANLEY |
Authorized Official - Middle Name: | AARON |
Authorized Official - Last Name: | MONTEE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DMD |
Authorized Official - Phone: | 931-220-9469 |
Mailing Address - Street 1: | 4219 HILLSBORO PIKE |
Mailing Address - Street 2: | STE 100 |
Mailing Address - City: | NASHVILLE |
Mailing Address - State: | TN |
Mailing Address - Zip Code: | 37215-3328 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 615-383-4494 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 4219 HILLSBORO PIKE |
Practice Address - Street 2: | STE 100 |
Practice Address - City: | NASHVILLE |
Practice Address - State: | TN |
Practice Address - Zip Code: | 37215-3328 |
Practice Address - Country: | US |
Practice Address - Phone: | 615-383-4494 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-04-07 |
Last Update Date: | 2016-04-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TN | 8301 | 122300000X |
TN | 8290 | 122300000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 122300000X | Dental Providers | Dentist | Group - Single Specialty |