Active NPI
Martha Harden Wells, DMD
- Pediatric Dentistry
- Memphis, TN
National Provider Identifier
1699861708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 9127
- Practice address
- 262 Danny Thomas Place
Dental Clinic
Memphis, TN 38105-3678 - Phone
- (901) 595-3622
- NPI assigned
- Oct 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 30022355 | OH | |
| Pediatric Dentistry | 1223P0221X | 9127 | TN | Primary |
Addresses
Primary practice location
262 Danny Thomas Place
Dental Clinic
Memphis, TN 38105-3678
Mailing address
262 Danny Thomas Place
Dental Clinic
Memphis, TN 38105-3678
Phone (901) 595-3622
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30022355 | OH | MD | Pediatric Dentist |
| 9127 | TN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Jude Children'S Research Hospital, Inc. | Current | Accepting new patients | |
| St Jude Children'S Research Hospital | Past | Accepting new patients |
Locations
262 Danny Thomas Pl
Memphis, TN 38105
Phone (888) 226-4343
262 Danny Thomas Pl
#515
Memphis, TN 38105
Phone (901) 495-3006
Organizations & group practices 2
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.
-
- Pediatrics Physician
- Memphis, TN
- NPI 1306335088
-
- Special Hospital
- Memphis, TN
- NPI 1821432212
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676851200000",
"number": "1699861708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "262 DANNY THOMAS PLACE",
"address_2": "DENTAL CLINIC",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381053678",
"telephone_number": "901-595-3622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "262 DANNY THOMAS PLACE",
"address_2": "DENTAL CLINIC",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381053678",
"telephone_number": "901-595-3622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "MARTHA",
"middle_name": "HARDEN",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-05",
"last_updated": "2023-02-20",
"certification_date": "2023-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "OH",
"license": "30022355",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TN",
"license": "9127",
"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 Feb 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.