# TIBBS FAMILY DENTISTRY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790326072
- **Authorized official:** JEREMY TIBBS (OWNER)
- **Authorized official phone:** (615) 540-0556

## Contact information

- **Practice address:** 5114 OLD HICKORY BLVD STE 200, HERMITAGE, TN 37076-2590
- **Practice address phone:** (615) 540-0556
- **Mailing address:** 1000 THORN HILL CT, HENDERSONVILLE, TN 37075-9613

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 10/08/2019
- **Last updated:** 10/08/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1532725 | — | TN |