NPIMap

Organization Active NPI

American Family Dentistry of Memphis, PC

Doing business as Prestige Dental Care

  • General Practice Dentistry
  • Memphis, TN
National Provider Identifier
1710648555
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
AMERICAN FAMILY DENTISTRY OF MEMPHIS, PC
Doing business as
Prestige Dental Care
Practice address
3267 Hacks Cross Rd
Memphis, TN 38125-8801
Phone
(901) 624-0440
Fax
(901) 421-6478
NPI assigned
Jan 4, 2022
Last updated
Oct 4, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
AMERICAN FAMILY DENTISTRY OF MEMPHIS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Authorized official

Name
Celia Hayes
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

3267 Hacks Cross Rd
Memphis, TN 38125-8801

Mailing address

3267 Hacks Cross Rd
Memphis, TN 38125-8801
Phone (901) 624-0440

Other names 1

  • Prestige Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Family Dentistry of Seymour23 organizations share this tax ID, including this one
Part of
Family Dentistry of Seymour

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

3267 Hacks Cross Rd
Memphis, TN 38125
Phone (901) 619-0347

Practitioners & affiliated clinicians

Practitioners 1

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": "1641254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1710648555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3267 HACKS CROSS RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258801",
            "telephone_number": "901-624-0440",
            "fax_number": "901-421-6478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3267 HACKS CROSS RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258801",
            "telephone_number": "901-624-0440",
            "fax_number": "901-421-6478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN FAMILY DENTISTRY OF MEMPHIS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMERICAN FAMILY DENTISTRY OF MEMPHIS, PC",
        "enumeration_date": "2022-01-04",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prestige Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 4, 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.