NPIMap

Organization Active NPI

Periodontal Associates of Memphis

  • Periodontics
  • Memphis, TN
National Provider Identifier
1023158185
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DS7731 Issued in TN
Legal business name
PERIODONTAL ASSOCIATES OF MEMPHIS
Practice address
6268 Poplar Ave
Memphis, TN 38119-4713
Phone
(901) 761-3770
Fax
(901) 761-3775
NPI assigned
Feb 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Barbara F Patton
Title
Office Manager
Phone
(901) 761-3770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X DS7731 TN Primary

Addresses

Primary practice location

6268 Poplar Ave
Memphis, TN 38119-4713

Mailing address

6268 Poplar Ave
Memphis, TN 38119-4713
Phone (901) 761-3770

National Provider Directory

National Provider Directory

Locations

6268 Poplar Ave
Memphis, TN 38119
Phone (901) 761-3770

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023158185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6268 POPLAR AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381194713",
            "telephone_number": "901-761-3770",
            "fax_number": "901-761-3775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6268 POPLAR AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381194713",
            "telephone_number": "901-761-3770",
            "fax_number": "901-761-3775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIODONTAL ASSOCIATES OF MEMPHIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PATTON",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "901-761-3770",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "TN",
            "license": "DS7731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.