Provider Demographics
NPI:1962077883
Name:STUMP, ALLISON (DMD)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:
Last Name:STUMP
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6311 KINGSTON PIKE STE 8W
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-4906
Mailing Address - Country:US
Mailing Address - Phone:865-584-8630
Mailing Address - Fax:865-584-6950
Practice Address - Street 1:150 E DIVISION RD STE 6
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6908
Practice Address - Country:US
Practice Address - Phone:865-482-1701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY10603122300000X
TN12043122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYKY6492Other6492