Individual provider Active NPI

Joseph Fard Dove, DDS

  • General Practice Dentistry
  • Memphis, TN
National Provider Identifier
1417026428
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7557 Issued in TN
Practice address
3030 Covington Pike Ste 150
Memphis, TN 38128-5041
Phone
(901) 213-9337
Fax
(901) 213-9447
NPI assigned
Nov 6, 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 7557 TN Primary

Addresses

Primary practice location

3030 Covington Pike Ste 150
Memphis, TN 38128-5041

Mailing address

3030 Covington Pike Ste 150
Memphis, TN 38128-5041
Phone (901) 213-9337

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
I20170210000902 TN Order and Referring Only - DentistPractitioner - Dentist 5294018545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7557TNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jaamac Dental Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417026428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 COVINGTON PIKE STE 150",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381285041",
            "telephone_number": "901-213-9337",
            "fax_number": "901-213-9447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 COVINGTON PIKE STE 150",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381285041",
            "telephone_number": "901-213-9337",
            "fax_number": "901-213-9447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOVE",
        "first_name": "JOSEPH",
        "middle_name": "FARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "7557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.