Southern Dental of Raleigh PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3930 Issued in AR

Legal business name

SOUTHERN DENTAL OF RALEIGH PLLC

Practice address

4283 Raleigh Millington Rd
Memphis, TN 38128-2207

Phone

(901) 372-1221

NPI assigned

Nov 13, 2017

Last updated

Nov 13, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. William Reynolds Little, DDS

Title

Owner

Phone

(870) 243-4406

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510531200000",
    "number": "1770096703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17151",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724036720",
            "telephone_number": "870-243-4406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4283 RALEIGH MILLINGTON RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381282207",
            "telephone_number": "901-372-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN DENTAL OF RALEIGH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-13",
        "last_updated": "2017-11-13",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "REYNOLDS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-243-4406",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southeast Urology Network PC
• Southeastern OB, LLC (Adams Patterson)
• Southern Cardiovascular PLLC
• Southern College of Optometry (University Eye Care)
• Southern College of Optometry
• Southern Eye Associates, PC
• Southern Home Care
• Southern Liberty Transportation Company (Southern Transit)
• Southern Medical Clinic
• Southern Physicians PLLC

• General Practice Dentistry in Memphis, TN
• Providers in Memphis, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2017; 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.