NPIMap

Organization Active NPI

Global Dental Center LLC

  • Dentist
  • Memphis, TN
National Provider Identifier
1114036886
Registry record updated Mar 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS5258 Issued in TN
Legal business name
GLOBAL DENTAL CENTER LLC
Practice address
3719 Riverdale Rd
Memphis, TN 38115-5322
Phone
(901) 527-5359
Fax
(901) 527-9909
NPI assigned
Aug 29, 2006
Last updated
Mar 1, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2013

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

Authorized official

Name
Dr. Delois Roberson, DDSNPI 1174852164
Title
Dr/Manager
Phone
(901) 527-5359

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS5258 TN Primary

Addresses

Primary practice location

3719 Riverdale Rd
Memphis, TN 38115-5322

Mailing address

3719 Riverdale Rd
Memphis, TN 38115-5322
Phone (901) 527-5359

Other identifiers 3

IdentifierTypeStateIssuer
1436826OtherTNBLUE CROSS BLUE SHIELD
791304OtherUNITED CONCORDIA
1530170MedicaidTN

National Provider Directory

National Provider Directory

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": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362096000000",
    "number": "1114036886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3719 RIVERDALE RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381155322",
            "telephone_number": "901-527-5359",
            "fax_number": "901-527-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3719 RIVERDALE RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381155322",
            "telephone_number": "901-527-5359",
            "fax_number": "901-527-9909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLOBAL DENTAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2013-03-01",
        "status": "A",
        "authorized_official_last_name": "ROBERSON",
        "authorized_official_first_name": "DELOIS",
        "authorized_official_title_or_position": "DR/MANAGER",
        "authorized_official_telephone_number": "901-527-5359",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "DS5258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1436826",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "791304",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1530170",
            "state": "TN"
        }
    ],
    "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 Mar 1, 2013; 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.