Max S. Breazeal, D.D.S.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MAX S. BREAZEAL, D.D.S.

Practice address

61 Peyton Pkwy Ste 103
Collierville, TN 38017-9724

Phone

(901) 861-0031

Fax

(901) 861-4031

NPI assigned

Oct 9, 2023

Organization subpart

No

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

Authorized official

Name

Lisa G Henley

Title

Office Manager

Phone

(901) 861-0031

Specialties & licenses 1

Addresses

Other names 1

• The Max Dental Center Other name

Locations

Practitioners 1

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

• Max S. Breazeal, DDS

  • General Practice Dentistry
  • Collierville, TN
  • NPI 1073523049
  NPD

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

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696809600000",
    "number": "1346021177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 PEYTON PKWY STE 103",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380179724",
            "telephone_number": "901-861-0031",
            "fax_number": "901-861-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 PEYTON PKWY STE 103",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380179724",
            "telephone_number": "901-861-0031",
            "fax_number": "901-861-4031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAX S. BREAZEAL, D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-09",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A",
        "authorized_official_last_name": "HENLEY",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "901-861-0031"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Max Dental Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Juan Martin
• Luke Maschmeyer, MD
• Rachel Maslowski, OCCUPATIONAL THERAPI
• Charles Mason, FNP
• Nazmeydi Matamoros
• Ryan Bentley Maxwell, PHARMD
• Brittany Michele May, DO
• Owita R Mays, MD
• Shandra Mbanga
• Carlene McAllister, FNP

• Dental Clinic/Center in Collierville, TN
• Providers in Collierville, TN by specialty
• Dental Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; 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.