Active NPI
Angela Gullard, DMD, PHD
- Dentist
- Memphis, TN
National Provider Identifier
1396299830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 10361
- Practice address
- 875 Union Ave
Advanced Prosthodontics Program
Memphis, TN 38103-3513 - Phone
- (256) 603-3791
- NPI assigned
- Aug 13, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 10361 | TN | Primary |
Addresses
Primary practice location
875 Union Ave
Advanced Prosthodontics Program
Memphis, TN 38103-3513
Mailing address
1173 Union Ave
Apt 307
Memphis, TN 38104-6650
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10361 | TN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471046400000",
"number": "1396299830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1173 UNION AVE",
"address_2": "APT 307",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381046650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "875 UNION AVE",
"address_2": "ADVANCED PROSTHODONTICS PROGRAM",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381033513",
"telephone_number": "256-603-3791"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GULLARD",
"first_name": "ANGELA",
"name_prefix": "Dr.",
"credential": "DMD, PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-13",
"last_updated": "2016-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TN",
"license": "10361",
"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 Aug 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.