Provider Demographics
NPI:1548475577
Name:NUNN, JANELL LYNN (DMD)
Entity type:Individual
Prefix:
First Name:JANELL
Middle Name:LYNN
Last Name:NUNN
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 1:7448 TWIN BROOKS BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-6254
Mailing Address - Country:US
Mailing Address - Phone:865-922-9239
Mailing Address - Fax:
Practice Address - Street 1:315 GILL AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-7209
Practice Address - Country:US
Practice Address - Phone:865-546-7330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS6942122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNDS6942OtherDENTAL LICENSE NUMBER
TNBS3892165OtherDEA NUMBER