Crosstown Dental Group LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CROSSTOWN DENTAL GROUP LLC

Practice address

1350 Concourse Ave Ste 446
Memphis, TN 38104-2026

Phone

(901) 881-1234

Fax

(901) 339-5995

NPI assigned

Sep 23, 2020

Organization subpart

No

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

Authorized official

Name

Daniel Bird, DDSNPI 1023026630

Title

Owner/Dentist

Phone

(901) 881-1234

Specialties & licenses 1

Addresses

Other names 1

• Crosstown Dental Group LLC Doing business as

Electronic endpoints 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel L Bird, DDS, PA

  • General Practice Dentistry
  • West Memphis, AR
  • NPI 1023026630

  General Practice

  NPD Authorized official
• Jessica Jordan, DDS

  • Dentist
  • Memphis, TN
  • NPI 1427431261

  General Practice

  NPD
• Randy Bagay, DDS

  • General Practice Dentistry
  • Saint Augustine, FL
  • NPI 1922626019

  General Practice

  NPD (past)

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600819200000",
    "number": "1467068569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 CONCOURSE AVE STE 446",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042026",
            "telephone_number": "901-881-1234",
            "fax_number": "901-339-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 CONCOURSE AVE STE 446",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042026",
            "telephone_number": "901-881-1234",
            "fax_number": "901-339-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSTOWN DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-23",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A",
        "authorized_official_last_name": "BIRD",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "901-881-1234",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "meghan.morrison@crosstowndentist.com",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "secure email",
            "address_1": "1350 Concourse Ave Ste 446",
            "city": "Memphis",
            "state": "TN",
            "country_code": "US",
            "postal_code": "381042026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Crosstown Dental Group LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Memphis, TN
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; 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.