Individual provider Active NPI

Maria Teresa Macaraeg, D.D.S.

  • General Practice Dentistry
  • Memphis, TN
National Provider Identifier
1639207293
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5415 Issued in TN
Practice address
Aspen Dental
2849 N Germantown Parkway
Memphis, TN 38133
Phone
(901) 248-4732
NPI assigned
Mar 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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 5415 TN Primary

Addresses

Primary practice location

Aspen Dental
2849 N Germantown Parkway
Memphis, TN 38133

Mailing address

11125 McCormick Road
Arlington, TN 38002-9100
Phone (901) 351-6205

Other identifiers 1

IdentifierTypeStateIssuer
3225881MedicaidTN

Other names 1

  • Dr. Teresa Macaraeg Other name

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
5415TNMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1639207293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11125 MCCORMICK ROAD",
            "city": "ARLINGTON",
            "state": "TN",
            "postal_code": "380029100",
            "telephone_number": "901-351-6205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ASPEN DENTAL",
            "address_2": "2849 N GERMANTOWN PARKWAY",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38133",
            "telephone_number": "901-248-4732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACARAEG",
        "first_name": "MARIA",
        "middle_name": "TERESA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "5415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3225881",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "MACARAEG",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Oct 27, 2021; 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.