NPIMap

Organization Active NPI

Monument Dental Anesthesia PLLC

  • Dental Anesthesiology
  • Memphis, TN
National Provider Identifier
1356891675
Registry record updated Feb 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AnesthesiologyTaxonomy code 1223D0004X
License
9030 Issued in TN
Legal business name
MONUMENT DENTAL ANESTHESIA PLLC
Practice address
120 S Grove Park Rd
Memphis, TN 38117-3104
Phone
(901) 491-0971
NPI assigned
Oct 11, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2017

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

Authorized official

Name
Dr. Russell D Morrell, DMD, MDSNPI 1972830750
Title
Owner
Phone
(901) 491-0971

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental AnesthesiologyGroup: 193400000X SINGLE SPECIALTY GROUP 1223D0004X 9030 TN Primary

Addresses

Primary practice location

120 S Grove Park Rd
Memphis, TN 38117-3104

Mailing address

120 S Grove Park Rd
Memphis, TN 38117-3104
Phone (901) 491-0971

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1476144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485907200000",
    "number": "1356891675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S GROVE PARK RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381173104",
            "telephone_number": "901-491-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S GROVE PARK RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381173104",
            "telephone_number": "901-491-0971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONUMENT DENTAL ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-11",
        "last_updated": "2017-02-01",
        "status": "A",
        "authorized_official_last_name": "MORRELL",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-491-0971",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MDS"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "TN",
            "license": "9030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 1, 2017; 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.