NPIMap

Organization Active NPI

Shoemaker Dental

  • Dental Clinic/Center
  • Memphis, TN
National Provider Identifier
1992392708
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
SHOEMAKER DENTAL
Practice address
6244 Poplar Ave Ste 100
Memphis, TN 38119-4729
Phone
(901) 682-5826
Fax
(901) 761-5674
NPI assigned
Dec 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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

Authorized official

Name
Melanie Cecile Churinetz, DDSNPI 1215282298
Title
President
Phone
(901) 692-5826

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

6244 Poplar Ave Ste 100
Memphis, TN 38119-4729

Mailing address

6244 Poplar Ave Ste 100
Memphis, TN 38119-4729
Phone (901) 682-5826

Other names 1

  • James G Sousoulas DDS Former legal business name

National Provider Directory

National Provider Directory

Locations

6244 Poplar Ave
Ste 100
Memphis, TN 38119
Phone (901) 682-5826

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": "1609113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609113600000",
    "number": "1992392708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6244 POPLAR AVE STE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381194729",
            "telephone_number": "901-682-5826",
            "fax_number": "901-761-5674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6244 POPLAR AVE STE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381194729",
            "telephone_number": "901-682-5826",
            "fax_number": "901-761-5674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOEMAKER DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-28",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A",
        "authorized_official_last_name": "CHURINETZ",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_middle_name": "CECILE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-692-5826",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "James G Sousoulas DDS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Dec 28, 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.