Individual provider Active NPI

John Sturdivant Winford III, DDS

  • Periodontics
  • Memphis, TN
National Provider Identifier
1740390020
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DS2606 PERIO 120 Issued in TN
Practice address
3980 New Covington Pike
#306
Memphis, TN 38128-2500
Phone
(901) 382-2887
Fax
(901) 382-2322
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X DS2606 PERIO 120 TN Primary

Addresses

Primary practice location

3980 New Covington Pike
#306
Memphis, TN 38128-2500

Mailing address

3980 New Covington Pike
#306
Memphis, TN 38128-2500
Phone (901) 382-2887

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

LicenseStateTypeSpecialty
DS2606 PERIO 120TNMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740390020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3980 NEW COVINGTON PIKE",
            "address_2": "#306",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381282500",
            "telephone_number": "901-382-2887",
            "fax_number": "901-382-2322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3980 NEW COVINGTON PIKE",
            "address_2": "#306",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381282500",
            "telephone_number": "901-382-2887",
            "fax_number": "901-382-2322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINFORD",
        "first_name": "JOHN",
        "middle_name": "STURDIVANT",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TN",
            "license": "DS2606 PERIO 120",
            "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 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.

Verify at the official NPI Registry.