Active NPI
Elite Dental Germantown PLC
- Dentist
- Germantown, TN
National Provider Identifier
1124552401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS009456
- Legal business name
- ELITE DENTAL GERMANTOWN PLC
- Practice address
- 9064 Corporate Gradens Drive
Germantown, TN 38138 - Phone
- (731) 855-1053
- Fax
- (731) 855-8064
- NPI assigned
- Apr 13, 2017
- Last updated
- Apr 13, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Michael Ryan Farrar, DDS
- Title
- Owner/ Dentist
- Phone
- (731) 855-1053
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS009456 | TN | Primary |
Addresses
Primary practice location
9064 Corporate Gradens Drive
Germantown, TN 38138
Mailing address
9064 Corporate Gradens Drive
Germantown, TN 38138
Phone (731) 855-1053
National Provider Directory
National Provider DirectoryPractitioners & 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.
-
- Dentist
- Trenton, TN
- NPI 1265793228
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492041600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1492041600000",
"number": "1124552401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9064 CORPORATE GRADENS DRIVE",
"city": "GERMANTOWN",
"state": "TN",
"postal_code": "38138",
"telephone_number": "731-855-1053",
"fax_number": "731-855-8064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9064 CORPORATE GRADENS DRIVE",
"city": "GERMANTOWN",
"state": "TN",
"postal_code": "38138",
"telephone_number": "731-855-1053",
"fax_number": "731-855-8064"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ELITE DENTAL GERMANTOWN PLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-04-13",
"last_updated": "2017-04-13",
"status": "A",
"authorized_official_last_name": "FARRAR",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "RYAN",
"authorized_official_title_or_position": "OWNER/ DENTIST",
"authorized_official_telephone_number": "731-855-1053",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "TN",
"license": "DS009456",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Germantown, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.