Provider Demographics
NPI:1992135131
Name:ADDERLY, ERICA J (DDS)
Entity type:Individual
Prefix:DR
First Name:ERICA
Middle Name:J
Last Name:ADDERLY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:J
Other - Last Name:MCFARLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:324 LONG HOLLOW PIKE STE 206
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-1853
Mailing Address - Country:US
Mailing Address - Phone:615-942-2185
Mailing Address - Fax:156-600-4879
Practice Address - Street 1:324 LONG HOLLOW PIKE STE 206
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-1853
Practice Address - Country:US
Practice Address - Phone:615-942-2185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-26
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20450122300000X
TN10343122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016363100Medicaid