David Michael Pencarinha

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

0000012159 Issued in TN

Practice address

6425 Stage Rd Ste 1
Bartlett, TN 38134-3731

Phone

(901) 754-8002

NPI assigned

Apr 29, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Germantown-Bartlett Oral Surgery Group, )P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Germantown, TN
  • NPI 1760531974
  NPD (past)

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

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1164043329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 OAKLAWN",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723649026",
            "telephone_number": "423-276-7459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 STAGE RD STE 1",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381343731",
            "telephone_number": "901-754-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENCARINHA",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-29",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "0000012159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maurice Payne
• Melvin Pelletier Payne III, MD
• Jennifer April Peacock, MSW, BCBA
• Marcel Antonette Pearson
• Alundra Renee Peete
• Samantha Elizabeth Person-Aldridge, DNP, PMHNP-BC,FNP-BC
• David C Pettey, D.M.D.
• Kari Nhi Pham, PA-C
• Steven Pham, PT, DPT
• Linh Phan

• Oral and Maxillofacial Surgery (Dentist) in Bartlett, TN
• Providers in Bartlett, TN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.