Active NPI
Nicholas Luke Egbert, D.D.S.
- Prosthodontics
- Memphis, TN
National Provider Identifier
1093965857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- DS0000008922
- Practice address
- 7535 Poplar Ave
Memphis, TN 38138-3812 - Phone
- (901) 754-4200
- Fax
- (901) 754-7511
- NPI assigned
- Sep 29, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | DS0000008922 | TN | Primary |
Addresses
Primary practice location
7535 Poplar Ave
Memphis, TN 38138-3812
Mailing address
7535 Poplar Ave
Memphis, TN 38138-3812
Phone (901) 754-4200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS0000008922 | TN | MD | Prosthodontist |
Networks
- UT PPO D-SNP
Interoperability endpoints
- negbert248992@direct.med.utah.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222646400000",
"number": "1093965857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7535 POPLAR AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381383812",
"telephone_number": "901-754-4200",
"fax_number": "901-754-7511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7535 POPLAR AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381383812",
"telephone_number": "901-754-4200",
"fax_number": "901-754-7511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EGBERT",
"first_name": "NICHOLAS",
"middle_name": "LUKE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-29",
"last_updated": "2008-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "TN",
"license": "DS0000008922",
"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 Sep 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.