Provider Demographics
NPI:1447998026
Name:SIFUENTES, AMBER LYNN (DMD)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:LYNN
Last Name:SIFUENTES
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 1:2215B KLINE AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-2127
Mailing Address - Country:US
Mailing Address - Phone:209-241-7018
Mailing Address - Fax:
Practice Address - Street 1:2658 NEW SALEM HWY STE A5
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128-5262
Practice Address - Country:US
Practice Address - Phone:615-768-8714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN118701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice