NPIMap

Organization Active NPI

Tennessee Dental Professionals, PC

Doing business as Poplar Dental Care

  • General Practice Dentistry
  • Collierville, TN
National Provider Identifier
1003329285
Registry record updated Nov 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TENNESSEE DENTAL PROFESSIONALS, PC
Doing business as
Poplar Dental Care
Practice address
1055 W Poplar Ave
Collierville, TN 38017-3180
Phone
(217) 540-5100
NPI assigned
Nov 10, 2017
Last updated
Nov 10, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
TENNESSEE DENTAL PROFESSIONALS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 10, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jessica Britt
Title
Credentialing Coordinator
Phone
(217) 540-8426

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1055 W Poplar Ave
Collierville, TN 38017-3180

Mailing address

1055 W Poplar Ave
Collierville, TN 38017-3180
Phone (217) 540-5100

Other names 1

  • Poplar Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
West Tennessee Dental Group66 organizations share this tax ID, including this one
Part of
West Tennessee Dental Group

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

1055 W Poplar Ave
Collierville, TN 38017
Phone (901) 457-0396

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1510272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510272000000",
    "number": "1003329285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 W POPLAR AVE",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380173180",
            "telephone_number": "217-540-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 W POPLAR AVE",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380173180",
            "telephone_number": "217-540-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE DENTAL PROFESSIONALS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TENNESSEE DENTAL PROFESSIONALS, PC",
        "enumeration_date": "2017-11-10",
        "last_updated": "2017-11-10",
        "status": "A",
        "authorized_official_last_name": "BRITT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8426"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Poplar Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Collierville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.