Provider Demographics
NPI:1215127931
Name:OWINGS, JAYSON ERIC (DDS)
Entity type:Individual
Prefix:DR
First Name:JAYSON
Middle Name:ERIC
Last Name:OWINGS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 N GATEWAY AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:ROCKWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37854-4214
Mailing Address - Country:US
Mailing Address - Phone:865-354-3910
Mailing Address - Fax:
Practice Address - Street 1:1124 N GATEWAY AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:ROCKWOOD
Practice Address - State:TN
Practice Address - Zip Code:37854-4214
Practice Address - Country:US
Practice Address - Phone:865-354-3910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0000008070122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist