NPIMap

Organization Active NPI

Tennessee Dental Professionals PC

Doing business as Audubon Dental Group

  • General Practice Dentistry
  • Memphis, TN
National Provider Identifier
1255760385
Registry record updated Sep 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TENNESSEE DENTAL PROFESSIONALS PC
Doing business as
Audubon Dental Group
Practice address
370 Colonial Road
3
Memphis, TN 38117
Phone
(901) 853-9800
NPI assigned
Nov 8, 2013
Last updated
Sep 17, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
TENNESSEE DENTAL PROFESSIONALS PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 17, 2014

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

Authorized official

Name
Kim Wilson
Title
Cred Supervisor
Phone
(217) 540-5170

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

370 Colonial Road
3
Memphis, TN 38117

Mailing address

370 Colonial Road
3
Memphis, TN 38117
Phone (901) 853-9800

Other names 1

  • Audubon Dental Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
West Tennessee Dental Group66 organizations share this tax ID, including this one
Part of
West Tennessee Dental Group

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410912000000",
    "number": "1255760385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 COLONIAL ROAD",
            "address_2": "3",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38117",
            "telephone_number": "901-853-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 COLONIAL ROAD",
            "address_2": "3",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38117",
            "telephone_number": "901-853-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE DENTAL PROFESSIONALS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TENNESSEE DENTAL PROFESSIONALS PC",
        "enumeration_date": "2013-11-08",
        "last_updated": "2014-09-17",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CRED SUPERVISOR",
        "authorized_official_telephone_number": "217-540-5170"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Audubon Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 17, 2014; 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.