NPIMap

Organization Active NPI

Churchwell Pediatric Dentistry

  • Pediatric Dentistry
  • Collierville, TN
National Provider Identifier
1184722324
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
3037302 Issued in TN
Legal business name
CHURCHWELL PEDIATRIC DENTISTRY
Doing business as
Dr Caroline Churchwell Dr Molly Churchwell
Practice address
1099 Poplar View Lane North
Collierville, TN 38017-9339
Phone
(901) 854-9555
Fax
(901) 853-4879
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Nancy P Turney
Title
Office Manager
Phone
(901) 854-9555

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 3037302 TN Primary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 3021033 TN

Addresses

Primary practice location

1099 Poplar View Lane North
Collierville, TN 38017-9339

Mailing address

1099 Poplar View Lane North
Collierville, TN 38017-9339
Phone (901) 854-9555

Other names 1

  • Dr Caroline Churchwell Dr Molly Churchwell Doing business as

National Provider Directory

National Provider Directory

Locations

1099 Poplar View Ln N
Collierville, TN 38017
Phone (901) 854-9555

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184722324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 POPLAR VIEW LANE NORTH",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380179339",
            "telephone_number": "901-854-9555",
            "fax_number": "901-853-4879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 POPLAR VIEW LANE NORTH",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380179339",
            "telephone_number": "901-854-9555",
            "fax_number": "901-853-4879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHURCHWELL PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TURNEY",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "901-854-9555"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "3037302",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "3021033",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr Caroline Churchwell Dr Molly Churchwell",
            "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 Aug 22, 2020; 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.