Shelby Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SHELBY DENTAL

Practice address

990 June Rd
Memphis, TN 38119-3702

Phone

(901) 767-2290

Fax

(901) 683-4524

NPI assigned

Oct 31, 2018

Organization subpart

No

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

Authorized official

Name

Shelby Dene Blaylock, DDS

Title

Dentist/Owner

Phone

(901) 767-2290

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Weber Winston Manning, DDS

  • General Practice Dentistry
  • Memphis, TN
  • NPI 1518149780
  NPD (past)

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540944000000",
    "number": "1063989754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 JUNE RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193702",
            "telephone_number": "901-767-2290",
            "fax_number": "901-683-4524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 JUNE RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193702",
            "telephone_number": "901-767-2290",
            "fax_number": "901-683-4524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELBY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-31",
        "last_updated": "2018-10-31",
        "status": "A",
        "authorized_official_last_name": "BLAYLOCK",
        "authorized_official_first_name": "SHELBY",
        "authorized_official_middle_name": "DENE",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "901-767-2290",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby County Health Care Corporation
• Shelby County Health Care Corporation
• Shelby County Health Care Corporation
• Shelby County Health Care Corporation
• Shelby County Physicians, PLLC
• Shelby Emergency Group LLC
• Shelby Health Services, LLC
• Shelby Residential & Vocational Services, Inc.
• Shelby Residential & Vocational Services, Inc.
• Shelby Residential & Vocational Services, Inc.

• General Practice Dentistry in Memphis, TN
• Providers in Memphis, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; 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.