NPIMap

Organization Active NPI

Edp of Tennessee PC

  • Dental Clinic/Center
  • Germantown, TN
National Provider Identifier
1780143800
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
EDP OF TENNESSEE PC
Practice address
7938 Wolf River Blvd
Germantown, TN 38138-1725
Phone
(901) 754-3117
NPI assigned
Mar 18, 2019
Organization subpart
Yes
Parent organization
EDP OF TENNESSEE PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Authorized official

Name
Roseanne Brunenkant
Title
Director of Integrations
Phone
(312) 937-3619

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

7938 Wolf River Blvd
Germantown, TN 38138-1725

Mailing address

141 W Jackson Blvd Ste 210
Chicago, IL 60604-3048
Phone (312) 937-3619

Other names 1

  • Christopher Cooley DDS Doing business as

National Provider Directory

National Provider Directory
Part of
Edp of Tennessee PC

Locations

7938 Wolf River Blvd
Germantown, TN 38138
Phone (901) 754-3117

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568592000000",
    "number": "1780143800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 W JACKSON BLVD STE 210",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043048",
            "telephone_number": "312-937-3619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7938 WOLF RIVER BLVD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381725",
            "telephone_number": "901-754-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDP OF TENNESSEE PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EDP OF TENNESSEE PC",
        "enumeration_date": "2019-03-18",
        "last_updated": "2019-09-16",
        "status": "A",
        "authorized_official_last_name": "BRUNENKANT",
        "authorized_official_first_name": "ROSEANNE",
        "authorized_official_title_or_position": "DIRECTOR OF INTEGRATIONS",
        "authorized_official_telephone_number": "312-937-3619"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Christopher Cooley DDS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Christopher Cooley DDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Germantown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; 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.