NPIMap

Organization Active NPI

University of Tennessee

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Memphis, TN
National Provider Identifier
1912556895
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
UNIVERSITY OF TENNESSEE
Doing business as
Pediatric Dental Clinic at LeBonheur
Practice address
848 Adams Ave.
Suite 101
Memphis, TN 38103-2816
Phone
(901) 448-5437
Fax
(901) 448-5438
NPI assigned
Sep 4, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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

Authorized official

Name
Mr. Anthony A Ferrara
Title
Sr. Vice Chancellor/ Chief Financia
Phone
(901) 448-5523

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

848 Adams Ave.
Suite 101
Memphis, TN 38103-2816

Mailing address

875 Union Ave.
Room E201
Memphis, TN 38103
Phone (901) 448-6224

Other names 1

  • Pediatric Dental Clinic at LeBonheur Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ut CT HLTH SC Fam Prac CT26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

848 Adams Ave
Ste 101
Memphis, TN 38103
Phone (901) 448-5437

875 Union Ave
Rm E201B
Memphis, TN 38103

Practitioners & affiliated clinicians

Practitioners 1

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": "1567555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581552000000",
    "number": "1912556895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 UNION AVE.",
            "address_2": "ROOM E201",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38103",
            "telephone_number": "901-448-6224",
            "fax_number": "901-448-2853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 ADAMS AVE.",
            "address_2": "SUITE 101",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032816",
            "telephone_number": "901-448-5437",
            "fax_number": "901-448-5438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF TENNESSEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-04",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A",
        "authorized_official_last_name": "FERRARA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SR. VICE CHANCELLOR/ CHIEF FINANCIA",
        "authorized_official_telephone_number": "901-448-5523",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Dental Clinic at LeBonheur",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pediatric Dental Clinic at LeBonheur",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 13, 2020; 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.