Provider Demographics
NPI:1942197637
Name:SCOTT, MAYA (DDS)
Entity type:Individual
Prefix:DR
First Name:MAYA
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 VICEROY TRL
Mailing Address - Street 2:
Mailing Address - City:MT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-2472
Mailing Address - Country:US
Mailing Address - Phone:214-927-6482
Mailing Address - Fax:
Practice Address - Street 1:120 W JACKSON ST
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-3918
Practice Address - Country:US
Practice Address - Phone:931-526-5460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12814122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist