Provider Demographics
NPI:1528298056
Name:ANWAY, JARED DOUGLAS (DDS)
Entity type:Individual
Prefix:DR
First Name:JARED
Middle Name:DOUGLAS
Last Name:ANWAY
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 1:7269 NOLENSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:NOLENSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37135-9492
Mailing Address - Country:US
Mailing Address - Phone:615-776-1050
Mailing Address - Fax:615-776-1051
Practice Address - Street 1:7269 NOLENSVILLE RD
Practice Address - Street 2:
Practice Address - City:NOLENSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37135
Practice Address - Country:US
Practice Address - Phone:615-776-1050
Practice Address - Fax:615-776-1051
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-17
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9018122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist