Provider Demographics
NPI:1972101145
Name:SMITH, ELIZABETH JAYNE (DMD, MSD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JAYNE
Last Name:SMITH
Suffix:
Gender:F
Credentials:DMD, MSD
Other - Prefix:MRS
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:IVEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10 BURTON HILLS BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-3012
Mailing Address - Country:US
Mailing Address - Phone:615-297-6997
Mailing Address - Fax:
Practice Address - Street 1:10 BURTON HILLS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-3012
Practice Address - Country:US
Practice Address - Phone:615-297-6997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-11
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000117321223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics