Prestige Dental DDS PC

Primary specialty

DentistTaxonomy code 122300000X

License

7908 Issued in TN

Legal business name

PRESTIGE DENTAL DDS PC

Practice address

3267 Hacks Cross Road
Memphis, TN 38125-2367

Phone

(901) 619-0347

NPI assigned

Dec 1, 2015

Organization subpart

No

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

Authorized official

Name

Kurt Holmes, DDS

Title

Owner/Dentist

Phone

(901) 619-0347

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458864000000",
    "number": "1831564962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 HACKS CROSS RD",
            "address_2": "SUITE 102-206",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381252367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3267 HACKS CROSS ROAD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381252367",
            "telephone_number": "901-619-0347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE DENTAL DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-01",
        "last_updated": "2016-03-25",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "KURT",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "901-619-0347",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TN",
            "license": "7908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1275602716",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Memphis, TN
• Providers in Memphis, TN by specialty
• Dentist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; 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.