Larry D Dormois, D.D.S, M.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

3545 Issued in TN

Practice address

875 Union Ave
Memphis, TN 38103

Phone

(901) 448-6240

NPI assigned

Dec 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dormois & Fuson, P.L.L.C.

  • Pediatric Dentistry
  • Southaven, MS
  • NPI 1639235963
  NPD (past)

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1386700839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7118 BELL MANOR CV",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381900",
            "telephone_number": "901-758-8066",
            "fax_number": "901-448-6249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38103",
            "telephone_number": "901-448-6240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "848 Adams Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381032816",
            "country_code": "US",
            "telephone_number": "901-448-5437",
            "fax_number": "901-448-5438",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "875 Union Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "38103",
            "country_code": "US",
            "telephone_number": "901-448-6240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DORMOIS",
        "first_name": "LARRY",
        "middle_name": "D",
        "credential": "D.D.S, M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MS",
            "license": "2335",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "3545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN PROVIDER",
            "identifier": "4031775",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6049",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109831608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Doran, DNP, CRNA
• Tammy Joy Doriot, DC
• Alyssa Christie Dorius, B.S.
• Michael T Dorkowski, O.D.
• Allyson Escott Dormois
• Sarah Burton Dormois, P.T.
• Leslie Ann Doros, MD
• Michael Alan Dorrity, M.D.
• Glenda Coxe Dorroh, NP-C
• Katherine Mittura Dorsett, M.D.

• Pediatric Dentistry in Memphis, TN
• Providers in Memphis, TN by specialty
• Pediatric Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; 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.