FIRESTONE DENTAL GROUP , P.L.L.C. (NPI# 1629129242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629129242 |
| Entity Type | Organization |
| Organization Name | FIRESTONE DENTAL GROUP , P.L.L.C. |
| Practice Address |
1216 Thomas St Memphis TN 38107-1703 |
| Practice Telephone | 9015253800 |
| Practice Fax Number | 9015254040 |
| Mailing Telephone | 9015253800 |
| Mailing Fax Number | 9015254040 |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2014-10-08 |
| Authorized Official Name | LOVELACE PRESTON GIPSON II (MANAGING MEMBER) |
| Authorized Official Telephone | 9015253800 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
2550 | TN | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1520609 | 05 |
| Street Address |
1216 THOMAS ST |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38107-1703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265422810 | Lovelace P Gipson II | Dentist | 1216 Thomas St, Memphis, TN 38107-1703 | 2005-10-25 |
| 1407169147 | Manise Labady | Dentist | 1216 Thomas St, Memphis, TN 38107-1703 | 2010-07-23 |
| 1578614160 | Brent Corin Johnson | Dentist | 1216 Thomas St, Memphis, TN 38107-1703 | 2007-01-12 |
| 1104816560 | Beverly H Lewis | Dentist | 1216 Thomas St, Memphis, TN 38107-1703 | 2005-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346801925 | Sarah E. Stevenson | Respiratory Therapist, Certified | 236 Caldwell Ave., Memphis, TN 38107 | 2019-06-25 |
| 1235516097 | Behavioral Healthcare Center At Memphis, Inc. | Psychiatric Hospital | 1505 N Second Street, Memphis, TN 38107 | 2015-04-30 |
| 1568732766 | Mary Geneva Scott | Pharmacist | 957 Elm Grove Cr, Collierville, TN 38107 | 2012-01-04 |
| 1053375634 | Harbor View Nursing and Rehabilitation Center Inc | Nursing Facility/Intermediate Care Facility | 1513 N 2nd St, Memphis, TN 38107 | 2006-04-12 |
| 1902289937 | Emily Williams | Speech-Language Pathologist | 1513 N 2nd St, Memphis, TN 38107-1003 | 2015-07-08 |
| 1043586498 | Jordan A Bunn | Occupational Therapist | 1513 N 2nd St, Memphis, TN 38107-1003 | 2012-03-30 |
| 1700186624 | Colleen M. Foeller | Occupational Therapy Assistant | 1513 N 2nd St, Memphis, TN 38107-1003 | 2010-10-26 |
| 1972818920 | Brian Matthew Defeo | Physical Therapist | 1513 N 2nd St, Memphis, TN 38107-1003 | 2010-08-15 |
| 1154635993 | Jonna Pfountz | Occupational Therapist | 1513 N 2nd St, Memphis, TN 38107-1003 | 2010-08-04 |
| 1891009643 | Montricia Renese Glenn | Occupational Therapist | 1513 N 2nd St, Memphis, TN 38107-1003 | 2010-08-04 |
| Find all providers in zip 38107 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497361596 | Crosstown Dental Group Highland Row LLC | Dentist | 431 S Highland St Ste 115, Memphis, TN 38111-1633 | 2020-09-23 |
| 1922626019 | Randy Bagay | Dentist | 1350 Concourse Ave Ste 446, Memphis, TN 38104-2026 | 2020-07-06 |
| 1780200279 | Taylor Rae Vracar | Dentist | 875 Union Ave Ste 301, Memphis, TN 38103-3513 | 2020-06-19 |
| 1063982957 | Jasmine Copelanddds | Dentist | 1251 Wesley Dr Ste 130, Memphis, TN 38116-6443 | 2018-12-04 |
| 1770075681 | Bellano East Memphis, Pllc | Dentist | 5336 Estate Office Dr Ste 1, Memphis, TN 38119-3623 | 2018-06-06 |
| 1992200364 | Lauren Alyssia Henderson | Dentist | 5180 Park Ave Ste 210, Memphis, TN 38119-3530 | 2018-03-28 |
| 1598123986 | James F Proctor Dds Pa | Dentist | 1655 International Drive, Suite 203, Memphis, TN 38120-1436 | 2016-02-01 |
| 1497140008 | Tennessee Dental Professionals PC | Dentist | 6425 N Quail Hollow Rd Ste 102, Memphis, TN 38120-1438 | 2015-03-31 |
| 1255760385 | Tennessee Dental Professionals PC | Dentist | 370 Colonial Road, 3, Memphis, TN 38117 | 2013-11-08 |
| 1457793929 | Acadia Helath LLC | Dentist | 1000 Ridgeway Loop Rd, Suite 203, Memphis, TN 38120-4045 | 2013-07-24 |
| 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.