| Kdnashvilledc | |
|
3901 Central Pike Ste 500 Hermitage TN 37076-3419 | |
| (812) 701-0213 | |
| Not Available |
| Full Name | Kdnashvilledc |
|---|---|
| Speciality | Dentist |
| Location | 3901 Central Pike Ste 500, Hermitage, Tennessee |
| Authorized Official Name and Position | Tanyika Wan (VP ADMINISTRATIVE SERVICES) |
| Authorized Official Contact | 8127010213 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kdnashvilledc 9200 Shelbyville Rd Ste 531 Louisville KY 40222-5132 Ph: () - | Kdnashvilledc 3901 Central Pike Ste 500 Hermitage TN 37076-3419 Ph: (812) 701-0213 |
| NPI Number | 1629767793 |
|---|---|
| Provider Enumeration Date | 05/04/2023 |
| Last Update Date | 08/14/2023 |
| Medicare PECOS PAC ID | 5991148009 |
|---|---|
| Medicare Enrollment ID | O20240206001724 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629767793 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Sarah Jane Pasch |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1619300787 PECOS PAC ID: 3173966231 Enrollment ID: I20240206003751 |
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