Individual provider Active NPI

Scott Alan Edwards, D.D.S.

  • General Practice Dentistry
  • Memphis, TN
National Provider Identifier
1376613711
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3914 Issued in TN
Practice address
266 S Cleveland St
Suite 103
Memphis, TN 38104-3533
Phone
(901) 728-6515
Fax
(901) 728-4005
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3914 TN Primary

Addresses

Primary practice location

266 S Cleveland St
Suite 103
Memphis, TN 38104-3533

Mailing address

266 S Cleveland St
Suite 103
Memphis, TN 38104-3533
Phone (901) 728-6515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150722004613 TN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8123331964

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376613711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "266 S CLEVELAND ST",
            "address_2": "SUITE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043533",
            "telephone_number": "901-728-6515",
            "fax_number": "901-728-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 S CLEVELAND ST",
            "address_2": "SUITE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043533",
            "telephone_number": "901-728-6515",
            "fax_number": "901-728-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "SCOTT",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "3914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.