NPIMap

Organization Active NPI

American Family Dentistry of Memphis, PC

Doing business as American Family Dentistry Cordova

  • General Practice Dentistry
  • Cordova, TN
National Provider Identifier
1053072942
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
AMERICAN FAMILY DENTISTRY OF MEMPHIS, PC
Doing business as
American Family Dentistry Cordova
Practice address
8095 Macon Rd Ste 109
Cordova, TN 38018-8500
Phone
(901) 754-4383
NPI assigned
Jan 4, 2022
Last updated
Jan 4, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
AMERICAN FAMILY DENTISTRY OF MEMPHIS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Authorized official

Name
Celia Hayes
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

8095 Macon Rd Ste 109
Cordova, TN 38018-8500

Mailing address

8095 Macon Rd Ste 109
Cordova, TN 38018-8500
Phone (901) 754-4383

Other names 1

  • American Family Dentistry Cordova Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Family Dentistry of Seymour23 organizations share this tax ID, including this one
Part of
Family Dentistry of Seymour

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

8095 Macon Rd
Ste 109
Cordova, TN 38018
Phone (901) 754-4383

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641254400000",
    "number": "1053072942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8095 MACON RD STE 109",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380188500",
            "telephone_number": "901-754-4383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8095 MACON RD STE 109",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380188500",
            "telephone_number": "901-754-4383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN FAMILY DENTISTRY OF MEMPHIS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMERICAN FAMILY DENTISTRY OF MEMPHIS, PC",
        "enumeration_date": "2022-01-04",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Family Dentistry Cordova",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cordova, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; 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.