MONUMENT DENTAL ANESTHESIA PLLC (NPI# 1356891675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356891675 |
| Entity Type | Organization |
| Organization Name | MONUMENT DENTAL ANESTHESIA PLLC |
| Practice Address |
120 S Grove Park Rd Memphis TN 38117-3104 |
| Practice Telephone | 9014910971 |
| Mailing Telephone | 9014910971 |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2017-02-01 |
| Authorized Official Name | DR. RUSSELL D MORRELL (OWNER) |
| Authorized Official Telephone | 9014910971 |
| Authorized Official Credential | DMD, MDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223D0004X |
Dentist Specialization: Dentist Anesthesiologist |
9030 | TN | Dental Providers |
| Street Address |
120 S GROVE PARK RD |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38117-3104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972830750 | Russell D Morrell | Dentist | 120 S Grove Park Rd, Memphis, TN 38117-3104 | 2009-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154980639 | Zup Medical Services, LLC | Clinic/Center | 4576 Poplar Avenue, Memphis, TN 38117 | 2019-06-10 |
| 1104386028 | Faith Christie Leigh Roby | Counselor | 4646 Poplar Ave Ste 510, Memphis, TN 38117 | 2019-03-25 |
| 1023511300 | Genita Lashonda Johnson-hammond | Specialist | 4565 Quince Rd, 1b, Memphis, TN 38117 | 2018-03-14 |
| 1023547494 | Rivka R Braverman | Licensed Practical Nurse | 5050 Sanderlin Avenue, Memphis, TN 38117 | 2017-06-08 |
| 1285002451 | Shauna Lomax | Physical Therapy Assistant | 258 Leonora Dr, Memphis, TN 38117 | 2015-09-04 |
| 1255735569 | Caring Hearts of The Mid South | In Home Supportive Care | 4646 Poplar, Suite 213b, Memphis, TN 38117 | 2014-10-15 |
| 1063821296 | Tomasz A Charowski | Dentist | 670 Colonial Rd Ste 3, Memphis, TN 38117 | 2014-08-13 |
| 1255760385 | Tennessee Dental Professionals PC | Dentist | 370 Colonial Road, 3, Memphis, TN 38117 | 2013-11-08 |
| 1447692264 | Dory Sellers | Dentist | 4515 Poplar Avenue, Suite 406, Memphis, TN 38117 | 2013-07-22 |
| 1366791808 | Amirio Jonte Armour | Pharmacist | 1760 Moriah Woods, Suite 2, Memphis, TN 38117 | 2012-08-30 |
| Find all providers in zip 38117 | ||||
| Taxonomy Code | 1223D0004X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Dentist Anesthesiologist |
| A dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation’s Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology. |
| Notes: Source: The American Society of Dentist Anesthesiologists [1/1/2013: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972830750 | Russell D Morrell | Dentist | 120 S Grove Park Rd, Memphis, TN 38117-3104 | 2009-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437510146 | Jeffrey Bryce Farr | Dentist | Noba 509 New Hwy 96, Suite 100, Franklin, TN 37064 | 2016-03-09 |
| 1255564340 | A (plus) Dental Associates, Inc. | Dentist | 234 E Gaines St, Lawrenceburg, TN 38464-3343 | 2009-08-24 |
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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.