Provider Demographics
NPI:1699589994
Name:TRI-CITIES DENTAL SERVICES LLC
Entity type:Organization
Organization Name:TRI-CITIES DENTAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. DIRECTOR OF EFFICIENCY SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:MAXWELL
Authorized Official - Middle Name:
Authorized Official - Last Name:JANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-761-5947
Mailing Address - Street 1:800 S GAY ST STE P325
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37929-9749
Mailing Address - Country:US
Mailing Address - Phone:678-761-5947
Mailing Address - Fax:
Practice Address - Street 1:800 S GAY ST STE P325
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37929-9749
Practice Address - Country:US
Practice Address - Phone:678-761-5947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty