Staples Dental LLC

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

Legal business name

STAPLES DENTAL LLC

Practice address

3021 Highway 45 Byp Ste 103
Jackson, TN 38305-0601

Phone

(731) 668-6700

NPI assigned

May 10, 2023

Last updated

Jun 27, 2023By 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

Randall Pope StaplesNPI 1558550707

Title

Member

Phone

(731) 668-6700

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Randall P Staples, D.D.S.

  • Dentist
  • Jackson, TN
  • NPI 1558550707
  NPD (past) Authorized official

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687824000000",
    "number": "1932899317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3021 HIGHWAY 45 BYP STE 103",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383050601",
            "telephone_number": "731-668-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3021 HIGHWAY 45 BYP STE 103",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383050601",
            "telephone_number": "731-668-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAPLES DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A",
        "authorized_official_last_name": "STAPLES",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "POPE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "731-668-6700"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayce Stafford, OTA
• Adrean Raquel Stamper, DNP
• Jennifer Standoff, LMSW
• Rebecca S Stanfield, LSPE
• Reba Stanley, RBT
• Randall P Staples, D.D.S.
• Star Center, Inc.
• State of Tennessee (West Tennessee Regional Office)
• State of Tennessee (West Tennessee Regional Health Office Communiable Disease Clinic)
• State of Tennessee

• Public Health Dentistry in Jackson, TN
• Providers in Jackson, TN by specialty
• Public Health Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.