Provider Demographics
NPI:1548852767
Name:DR. SARAH HUMPHREYS PLLC
Entity type:Organization
Organization Name:DR. SARAH HUMPHREYS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:HUMPHREYS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:770-328-9963
Mailing Address - Street 1:133 GARDENIA WAY
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-4738
Mailing Address - Country:US
Mailing Address - Phone:770-328-9963
Mailing Address - Fax:
Practice Address - Street 1:2000 TOLLGATE BLVD STE 205
Practice Address - Street 2:
Practice Address - City:THOMPSONS STATION
Practice Address - State:TN
Practice Address - Zip Code:37179-1005
Practice Address - Country:US
Practice Address - Phone:615-656-0854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-09
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty