NPIMap

Organization Active NPI

American Family Dentistry of Memphis, PC

Doing business as American Family Dentistry Collierville

  • General Practice Dentistry
  • Collierville, TN
National Provider Identifier
1124788229
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
AMERICAN FAMILY DENTISTRY OF MEMPHIS, PC
Doing business as
American Family Dentistry Collierville
Practice address
2130 W Poplar Ave Ste 106
Collierville, TN 38017-0615
Phone
(901) 861-7007
Fax
(901) 861-7066
NPI assigned
Dec 30, 2021
Last updated
Jan 5, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
AMERICAN FAMILY DENTISTRY OF MEMPHIS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Authorized official

Name
Celia Hayes
Title
Credentialingcoordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

2130 W Poplar Ave Ste 106
Collierville, TN 38017-0615

Mailing address

2130 W Poplar Ave Ste 106
Collierville, TN 38017-0615
Phone (901) 861-7007

Other names 1

  • American Family Dentistry Collierville Doing business as

National Provider Directory

National Provider Directory
Tax ID family
American Family Dentistry23 organizations share this tax ID, including this one
Part of
American Family Dentistry

Other organizations with this tax ID 22

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

View all 22

Locations

2130 W Poplar Ave
Collierville, TN 38017

2130 W Poplar Ave
Ste 106
Collierville, TN 38017
Phone (901) 861-7007

Practitioners & affiliated clinicians

Practitioners 2

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": "1640822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641340800000",
    "number": "1124788229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 W POPLAR AVE STE 106",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170615",
            "telephone_number": "901-861-7007",
            "fax_number": "901-861-7066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 W POPLAR AVE STE 106",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170615",
            "telephone_number": "901-861-7007",
            "fax_number": "901-861-7066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN FAMILY DENTISTRY OF MEMPHIS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMERICAN FAMILY DENTISTRY OF MEMPHIS, PC",
        "enumeration_date": "2021-12-30",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALINGCOORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Family Dentistry Collierville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "American Family Dentistry Collierville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Collierville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.