PEDIATRIC DENTISTRY OF MEMPHIS PLLC (NPI# 1609400431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609400431 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC DENTISTRY OF MEMPHIS PLLC |
| Practice Address |
6425 N Quail Hollow Rd Ste 101 Memphis TN 38120-1438 |
| Mailing Address |
1594 Old Mill Rd Germantown TN 38138-2124 |
| Practice Telephone | 9018619668 |
| Mailing Telephone | 9015988500 |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2020-07-20 |
| Authorized Official Name | DR. DAVID CALVIN HARRIS (PRESIDENT) |
| Authorized Official Telephone | 9015988500 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q029348 | 05 |
| Street Address |
6425 N QUAIL HOLLOW RD STE 101 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38120-1438 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497283691 | David Calvin Harris | Dentist | 6425 N Quail Hollow Rd Ste 101, Memphis, TN 38120-1438 | 2017-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093285637 | Cobblestone Midwifery | Midwife | 5617 Ashley Square South, Memphis, TN 38120 | 2018-11-27 |
| 1649768870 | River City Neuropsychology, Pllc | Psychologist | 1661 International Dr., Suite 400, Memphis, TN 38120 | 2018-04-24 |
| 1841676152 | Jody Lavaun Clements | Dentist | 795 Ridge Lake Blvd Ste 101, Memphis, TN 38120 | 2015-08-10 |
| 1578957122 | Christina Lumpkin | Nurse Practitioner | 6305 Humphreys Blvd Ste 101, Memphis, TN 38120 | 2015-03-21 |
| 1316352099 | Daniel Poor | Emergency Medicine | Baptist Memorial Hospital Memphis, 124 N. Humphrey's Blvd, Memphis, TN 38120 | 2014-06-21 |
| 1245643246 | Kysha Saleem | Nurse Practitioner | 6027 Walnut Grove Rd., Suite 312, Memphis, TN 38120 | 2014-06-06 |
| 1376962613 | John Christopher Swearingen | Dentist | 780 Ridge Lake Blvd Ste 101, Memphis, TN 38120 | 2014-04-15 |
| 1275884645 | Rebecca Leigh Goedecke | Nurse Practitioner | 6215 Humphreys Blvd Ste 301, Memphis, TN 38120 | 2012-09-26 |
| 1730475179 | Sarah Elizabeth Hammond | Surgery | Plastic Surgery Group, 80 Humphreys Blvd #100, Memphis, TN 38120 | 2011-06-23 |
| 1922302785 | Daniel L Hester | Nurse Anesthetist, Certified Registered | 1755 Kirby Parkway Suite 330, Memphis, TN 38120 | 2011-01-07 |
| Find all providers in zip 38120 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356775134 | Michael D. Blen Dds PC | Dentist | 6363 Poplar Ave Ste 110, Memphis, TN 38119-4802 | 2013-08-28 |
| 1770880064 | Miller Dental Health | Dentist | 5124 Stage Rd Ste C-2, Memphis, TN 38134-3164 | 2011-02-22 |
| 1710191812 | Ashley Suzanne Ramsey | Dentist | Ut College of Medicine 920 Madison Ave, Suite C50, Memphis, TN 38163-0001 | 2007-05-09 |
| 1538382502 | Courtney Lillianne Wilson | Dentist | 3285 Hacks Cross Rd, Ste 101, Memphis, TN 38125-8918 | 2007-04-10 |
| 1023147790 | Bradley W Wilkinson | Dentist | 5040 Sanderlin Avenue, Suite 101, Memphis, TN 38117 | 2007-03-05 |
| 1790858272 | Harry K. Sharp | Dentist | 875 Union Ave Rm S219, Memphis, TN 38163-0001 | 2006-11-15 |
| 1922197250 | Daniel Derrick Freeman | Dentist | 2567 Appling Rd, Memphis, TN 38133-5099 | 2006-10-12 |
| 1962597971 | Gregory Todd Wilkinson | Dentist | 5610 Murray Rd, Memphis, TN 38119 | 2006-10-04 |
| 1174511604 | Michael D. Blen | Dentist | 6363 Poplar Ave, Suite 110, Memphis, TN 38119-4831 | 2005-10-10 |
| 1760482046 | Sheldon Maurice Graves | Dentist | 4137 Kirby Pkwy, Suite 4, Memphis, TN 38115-6532 | 2005-07-28 |
| Find all providers in MEMPHIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.