NPIMap

Organization Active NPI

American Family Dentistry

Doing business as Collierville Family Dentistry

  • General Practice Dentistry
  • Collierville, TN
National Provider Identifier
1346381977
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
AMERICAN FAMILY DENTISTRY
Doing business as
Collierville Family Dentistry
Practice address
2130 W Poplar Ave
Suite 106
Collierville, TN 38017-0615
Phone
(901) 861-7007
Fax
(901) 861-7066
NPI assigned
Feb 8, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
AMERICAN DENTAL PARTNERS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Ms. Denise M Harris
Title
Practice Manager
Phone
(901) 861-7098

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X TN Primary

Addresses

Primary practice location

2130 W Poplar Ave
Suite 106
Collierville, TN 38017-0615

Mailing address

2130 W Poplar Ave
Suite 106
Collierville, TN 38017-0615
Phone (901) 861-7007

Other identifiers 1

IdentifierTypeStateIssuer
1700905080OtherTNGENERAL DENTIST

Other names 1

  • Collierville Family Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Family Dentistry of Seymour23 organizations share this tax ID, including this one
Part of
Family Dentistry of Seymour

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

2130 W Poplar Ave
Ste 106
Collierville, TN 38017
Phone (901) 861-7007

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1346381977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 W POPLAR AVE",
            "address_2": "SUITE 106",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170615",
            "telephone_number": "901-861-7007",
            "fax_number": "901-861-7066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 W POPLAR AVE",
            "address_2": "SUITE 106",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170615",
            "telephone_number": "901-861-7007",
            "fax_number": "901-861-7066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN FAMILY DENTISTRY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMERICAN DENTAL PARTNERS, INC",
        "enumeration_date": "2007-02-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "901-861-7098",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL DENTIST",
            "identifier": "1700905080",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Collierville Family Dentistry",
            "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 Jul 21, 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.