NPIMap

Organization Active NPI

Dental Implant Aesthetic Center

Doing business as Oral and Facial Surgical Specialists

  • Oral and Maxillofacial Surgery (Dentist)
  • Collierville, TN
National Provider Identifier
1720469075
Registry record updated Jun 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS5359 Issued in TN
Legal business name
DENTAL IMPLANT AESTHETIC CENTER
Doing business as
Oral and Facial Surgical Specialists
Practice address
1100 Poplar View LN N
Collierville, TN 38017-9323
Phone
(901) 854-4422
NPI assigned
Jun 12, 2015
Last updated
Jun 12, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2015

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

Authorized official

Name
Dr. Darren R Williams, DDSNPI 1629075619
Title
Owner
Phone
(901) 854-4422

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS5359 TN Primary

Addresses

Primary practice location

1100 Poplar View LN N
Collierville, TN 38017-9323

Mailing address

1100 Poplar View LN N
Collierville, TN 38017-9323
Phone (901) 854-4422

Other names 1

  • Oral and Facial Surgical Specialists Doing business as

National Provider Directory

National Provider Directory

Locations

1100 Poplar View Ln N
Collierville, TN 38017
Phone (901) 854-4422

Practitioners & affiliated clinicians

Practitioners 2

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": "1434067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434067200000",
    "number": "1720469075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 POPLAR VIEW LN N",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380179323",
            "telephone_number": "901-854-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 POPLAR VIEW LN N",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380179323",
            "telephone_number": "901-854-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL IMPLANT AESTHETIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-12",
        "last_updated": "2015-06-12",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DARREN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-854-4422",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "DS5359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oral and Facial Surgical Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Collierville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2015; 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.