Individual provider Active NPI

Amanda Leah Heard, RDH

  • Dental Hygienist
  • Memphis, TN
National Provider Identifier
1689480451
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
6220 Issued in TN
Practice address
5112 Stage Rd Ste 4
Memphis, TN 38134-3160
Phone
(901) 372-7906
NPI assigned
Dec 6, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 6220 TN Primary

Addresses

Primary practice location

5112 Stage Rd Ste 4
Memphis, TN 38134-3160

Mailing address

3210 Falling Star CV
Bartlett, TN 38134-1801
Phone (901) 337-3370

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

NPI Registry JSON

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

{
    "created_epoch": "1733443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1689480451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 FALLING STAR CV",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381341801",
            "telephone_number": "901-337-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5112 STAGE RD STE 4",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381343160",
            "telephone_number": "901-372-7906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEARD",
        "first_name": "AMANDA",
        "middle_name": "LEAH",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-06",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "TN",
            "license": "6220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 6, 2024; 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.