Full Throttle Dental, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FULL THROTTLE DENTAL, PLLC

Practice address

6630 Summer Knoll Cir Ste 103
Bartlett, TN 38134-2926

Phone

(901) 377-5060

NPI assigned

Jul 29, 2022

Organization subpart

No

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

Authorized official

Name

Misti Ross

Title

Insurance Director

Phone

(870) 336-3732

Specialties & licenses 1

Addresses

Other names 1

• Higginbotham Family Dental Doing business as

Locations

Practitioners 2

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

• Alan O. Blanton, D.D.S.

  • General Practice Dentistry
  • Collierville, TN
  • NPI 1750494951
  NPD (past)
• Alexis Bourgeois, DDS

  • General Practice Dentistry
  • Bartlett, TN
  • NPI 1063142701
  NPD (past)

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

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664236800000",
    "number": "1336875558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 OLD GREENSBORO RD BLDG B",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724050003",
            "telephone_number": "870-336-3732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6630 SUMMER KNOLL CIR STE 103",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381342926",
            "telephone_number": "901-377-5060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "362 New Byhalia Rd",
            "address_purpose": "LOCATION",
            "city": "Collierville",
            "state": "TN",
            "postal_code": "380173731",
            "country_code": "US",
            "telephone_number": "901-853-8116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FULL THROTTLE DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "MISTI",
        "authorized_official_title_or_position": "INSURANCE DIRECTOR",
        "authorized_official_telephone_number": "870-336-3732"
    },
    "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": "Higginbotham Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Freedom in Mobility, LLC
• Diana Freyaldenhoven
• Leigha Friener, MA-CCC-SLP
• Frontlines Wellness Center PLLC
• Leah Fryar, M.D.
• Keith Quentin Fulton, CRNA
• Joanna H Fussell, BCBA
• Keith Baugus Fussell, LPC, LMFT
• Rex Joseph Gaines, FNP-C
• Melanie A Gallimore, MA

• General Practice Dentistry in Bartlett, TN
• Providers in Bartlett, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.