Organization Active NPI

Mid-South TMJ & Sleep Apnea Dental Treatment Ctr LLC

  • General Practice Dentistry
  • Memphis, TN
National Provider Identifier
1386454585
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MID-SOUTH TMJ & SLEEP APNEA DENTAL TREATMENT CTR LLC
Practice address
795 Ridge Lake Blvd Ste 106
Memphis, TN 38120-9475
Phone
(901) 468-7088
Fax
(901) 221-2280
NPI assigned
Jan 9, 2025
Last updated
Jan 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Authorized official

Name
Dr. Elizabeth Graham MitchellNPI 1770711384
Title
Dentist, Owner
Phone
(901) 468-7088

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary
Durable Medical Equipment & Medical Supplies 332B00000X NU

Addresses

Primary practice location

795 Ridge Lake Blvd Ste 106
Memphis, TN 38120-9475

Mailing address

795 Ridge Lake Blvd Ste 106
Memphis, TN 38120-9475
Phone (901) 468-7088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260318004068 TN DME Supplier - Oral Surgery - Dentist 6204310105 Practice locations: Memphis, TN

National Provider Directory

National Provider Directory

Locations

795 Ridge Lake Blvd
Ste 106
Memphis, TN 38120
Phone (901) 468-7088

Practitioners & affiliated clinicians

Practitioners 1

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": "1736380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767744000000",
    "number": "1386454585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 RIDGE LAKE BLVD STE 106",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209475",
            "telephone_number": "901-468-7088",
            "fax_number": "901-221-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 RIDGE LAKE BLVD STE 106",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209475",
            "telephone_number": "901-468-7088",
            "fax_number": "901-221-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-SOUTH TMJ & SLEEP APNEA DENTAL TREATMENT CTR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-09",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "GRAHAM",
        "authorized_official_title_or_position": "DENTIST, OWNER",
        "authorized_official_telephone_number": "901-468-7088",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Jan 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.