Active NPI
James Benton Selecman, DDS
- Pediatric Dentistry
- Collierville, TN
National Provider Identifier
1730276106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 8501
- Practice address
- 2028 W Poplar Ave
Ste 110
Collierville, TN 38017-0618 - Phone
- (901) 861-9668
- Fax
- (901) 861-9582
- NPI assigned
- Oct 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 8501 | TN | Primary |
Addresses
Primary practice location
2028 W Poplar Ave
Ste 110
Collierville, TN 38017-0618
Mailing address
826 Bayou Vista Dr
Marion, AR 72364
Phone (870) 739-3364
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8501 | TN | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730276106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "826 BAYOU VISTA DR",
"city": "MARION",
"state": "AR",
"postal_code": "72364",
"telephone_number": "870-739-3364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2028 W POPLAR AVE",
"address_2": "STE 110",
"city": "COLLIERVILLE",
"state": "TN",
"postal_code": "380170618",
"telephone_number": "901-861-9668",
"fax_number": "901-861-9582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELECMAN",
"first_name": "JAMES",
"middle_name": "BENTON",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TN",
"license": "8501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.