Individual provider Active NPI

Emily Elizabeth Suffridge

  • Dentist
  • Germantown, TN
National Provider Identifier
1629964366
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12839 Issued in TN
Practice address
9407 Poplar Ave
Germantown, TN 38138-8003
Phone
(901) 309-6821
NPI assigned
Jun 17, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12839 TN Primary

Addresses

Primary practice location

9407 Poplar Ave
Germantown, TN 38138-8003

Mailing address

1335 Harbor Park Dr
Memphis, TN 38103-9030

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

State licenses

LicenseStateTypeSpecialty
12839TNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Dental Professionals PC CurrentSince Jun 23, 2025 Accepting new patients

Locations

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

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": "1750118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1629964366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 HARBOR PARK DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381039030"
        },
        {
            "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": {
        "last_name": "SUFFRIDGE",
        "first_name": "EMILY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-17",
        "last_updated": "2025-06-17",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "12839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 17, 2025; 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.