Provider Demographics
NPI:1316770852
Name:CONRY, TIFFANY LEANE (RDH, BSDH)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:LEANE
Last Name:CONRY
Suffix:
Gender:F
Credentials:RDH, BSDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 DONELSON PIKE STE 150
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3558
Mailing Address - Country:US
Mailing Address - Phone:615-802-6402
Mailing Address - Fax:
Practice Address - Street 1:441 DONELSON PIKE STE 150
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-3558
Practice Address - Country:US
Practice Address - Phone:615-802-6402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9985124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist