NPIMap

Organization Active NPI

Tennessee Dental Professionals PC

Doing business as Great Southern Smiles

  • General Practice Dentistry
  • Germantown, TN
National Provider Identifier
1487057162
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TENNESSEE DENTAL PROFESSIONALS PC
Doing business as
Great Southern Smiles
Practice address
9407 Poplar Ave
Germantown, TN 38138-8003
Phone
(901) 309-6821
NPI assigned
Oct 8, 2014
Last updated
Mar 15, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
TENNESSEE DENTAL PROFESSIONALS PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Authorized official

Name
Belinda Huerta
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

9407 Poplar Ave
Germantown, TN 38138-8003

Mailing address

9407 Poplar Ave
Germantown, TN 38138-8003
Phone (901) 309-6821

Other names 1

  • Great Southern Smiles Doing business as

National Provider Directory

National Provider Directory
Tax ID family
West Tennessee Dental Group66 organizations share this tax ID, including this one
Part of
West Tennessee Dental Group

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

3106 Professional Plz
Germantown, TN 38138
Phone (901) 309-6821

9407 Poplar Ave
Germantown, TN 38138
Phone (901) 309-6821

Practitioners & affiliated clinicians

Practitioners 7

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": "1412726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678838400000",
    "number": "1487057162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9407 POPLAR AVE",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381388003",
            "telephone_number": "901-309-6821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9407 POPLAR AVE",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381388003",
            "telephone_number": "901-309-6821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE DENTAL PROFESSIONALS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TENNESSEE DENTAL PROFESSIONALS PC",
        "enumeration_date": "2014-10-08",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A",
        "authorized_official_last_name": "HUERTA",
        "authorized_official_first_name": "BELINDA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Southern Smiles",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Great Southern Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Germantown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.