NPIMap

Organization Active NPI

University of Tennessee

  • Oral and Maxillofacial Surgery Clinic/Center
  • Memphis, TN
National Provider Identifier
1053385963
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
Legal business name
UNIVERSITY OF TENNESSEE
Practice address
875 Union Ave
Room C209
Memphis, TN 38103-0001
Phone
(901) 448-6267
Fax
(901) 448-2853
NPI assigned
Feb 15, 2006
Organization subpart
Yes
Parent organization
UNIVERSITY OF TENNESSEEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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

Authorized official

Name
Mr. Anthony A Ferrara
Title
Sr Vice Chancellor Chief Financial
Phone
(901) 448-5523

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X Primary

Addresses

Primary practice location

875 Union Ave
Room C209
Memphis, TN 38103-0001

Mailing address

875 Union Ave
Room E201
Memphis, TN 38103
Phone (901) 448-6224

Other identifiers 1

IdentifierTypeStateIssuer
8784OtherTNSTATE LICENSE

Other names 1

  • College of Dentistry - Operatory Other name

National Provider Directory

National Provider Directory
Tax ID family
Ut CT HLTH SC Fam Prac CT26 organizations share this tax ID, including this one
Part of
Ut CT HLTH SC Fam Prac CT

Other organizations with this tax ID 25

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

View all 25

Locations

875 Union Ave
Rm E201
Memphis, TN 38103

875 Union Ave
Rm C209
Memphis, TN 38103
Phone (901) 448-6267

Practitioners & affiliated clinicians

Practitioners 1

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": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581552000000",
    "number": "1053385963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 UNION AVE",
            "address_2": "ROOM E201",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38103",
            "telephone_number": "901-448-6224",
            "fax_number": "901-448-2853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 UNION AVE",
            "address_2": "ROOM C209",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381030001",
            "telephone_number": "901-448-6267",
            "fax_number": "901-448-2853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF TENNESSEE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF TENNESSEE",
        "enumeration_date": "2006-02-15",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A",
        "authorized_official_last_name": "FERRARA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SR VICE CHANCELLOR CHIEF FINANCIAL",
        "authorized_official_telephone_number": "901-448-5523",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "8784",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "College of Dentistry - Operatory",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "College of Dentistry - Operatory",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Feb 13, 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.