UNIVERSITY OF TENNESSEE (NPI# 1912556895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912556895 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF TENNESSEE |
| Other Organization Name | PEDIATRIC DENTAL CLINIC AT LEBONHEUR |
| Practice Address |
848 Adams Ave. Suite 101 Memphis TN 38103-2816 |
| Mailing Address |
875 Union Ave. Room E201 Memphis TN 38103 |
| Practice Telephone | 9014485437 |
| Practice Fax Number | 9014485438 |
| Mailing Telephone | 9014486224 |
| Mailing Fax Number | 9014482853 |
| Enumeration Date | 2019-09-04 |
| Last Update Date | 2020-02-13 |
| Authorized Official Name | MR. ANTHONY A FERRARA (SR. VICE CHANCELLOR/ CHIEF FINANCIA) |
| Authorized Official Telephone | 9014485523 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | Dental Providers | ||
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers | ||
| N | 1223P0700X |
Dentist Specialization: Prosthodontics |
Dental Providers | ||
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Pediatric Dental Clinic at LeBonheur | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902278179 | University of Tennessee | Anaplastologist | 875 Union Ave., Rooms S510b, Memphis, TN 38163-0001 | 2015-10-27 |
| 1740577428 | University of Tennessee | Student in an Organized Health Care Education/Training Program | 62 N Main St, Memphis, TN 38103 | 2011-07-01 |
| 1366756082 | University of Tennessee | Clinical Nurse Specialist | 220 Langland Street, Knoxville, TN 37915 | 2010-08-05 |
| 1033345541 | University of Tennessee | Special Hospital | 60 Harbor Town Sq, Memphis, TN 38103-8850 | 2009-06-10 |
| 1518037183 | University of Tennessee | Medical Genetics, Ph.D. Medical Genetics | 1930 Alcoa Hwy Ste 435, Ut Genetics Center, Knoxville, TN 37920-1520 | 2006-11-09 |
| 1427064880 | University of Tennessee | Clinic/Center | 711 Jefferson Avenue, Memphis, TN 38105-5003 | 2006-07-31 |
| 1386625846 | University of Tennessee | Audiologist | 1600 Peyton Manning Pass, Knoxville, TN 37996-0001 | 2005-11-10 |
| 1780686170 | University of Tennessee | Family Medicine | 1301 Primacy Pkwy, Memphis, TN 38119-0213 | 2005-08-15 |
| 1235666793 | University of Tennessee | General Acute Care Hospital | 920 Madison Ave, Suite 447, Memphis, TN 38103-3438 | 2017-05-16 |
| 1427420561 | University of Tennessee | Dentist | 875 Union Ave., Suite C303, Memphis, TN 38103-3513 | 2015-10-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | UNIVERSITY OF TENNESSEE | 304 Administration Bldg, Martin, TN 38238-0001 |
| System for Award Management (SAM) Entities | UNIVERSITY OF TENNESSEE AT CHATTANOOGA | 615 Mccallie Ave, Chattanooga, TN 37403-2504 |
| System for Award Management (SAM) Entities | UNIVERSITY OF TENNESSEE BUSINESS AFFAIRS | 116 Administration Bldg, Martin, TN 38238-0001 |
| System for Award Management (SAM) Entities | UNIVERSITY OF TENNESSEE INSTITUTE OF PUBLIC SERVICE/TENNESSEE LANGUAGE CENTER | 220 French Landing Dr Ste 1b, Nashville, TN 37243-1002 |
| System for Award Management (SAM) Entities | UNIVERSITY OF TENNESSEE RESEARCH FOUNDATION | 600 Henley St Ste 211, Knoxville, TN 37996-0001 |
| Street Address |
848 ADAMS AVE. SUITE 101 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38103-2816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659337855 | James Wheless | Psychiatry & Neurology | 848 Adams Ave., Ste. L400, Memphis, TN 38105 | 2006-04-25 |
| 1740765940 | Haley Miranda Freeman | Nurse Practitioner | 848 Adams Ave., Ste. L400, Memphis, TN 38103 | 2018-10-03 |
| 1780169441 | Brianna Megan Dale | Nurse Practitioner | 848 Adams Ave., Ste. L400, Memphis, TN 38103 | 2018-09-28 |
| 1992287213 | Jessica Arean Pliego | Clinical Neuropsychologist | 848 Adams Ave., Ste. L400, Memphis, TN 38103 | 2018-09-04 |
| 1093024101 | Ut Lebonheur Pediatric Specialists, Inc. | Dermatology | 848 Adams Ave., Memphis, TN 38103 | 2010-10-07 |
| 1184870958 | Namrata Samir Shah | Psychiatry & Neurology | 848 Adams Ave., Ste. L400, Memphis, TN 38103 | 2008-08-13 |
| 1528278223 | Basanagoud Mudigoudar | Psychiatry & Neurology | 848 Adams Ave., Ste.l400, Memphis, TN 38103 | 2007-05-23 |
| 1649309394 | Robin Lynne Jack | Psychiatry & Neurology | 848 Adams Ave., Ste. L400, Memphis, TN 38103 | 2007-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619505724 | Michelle Lynn Esposito | Dietitian, Registered | 1st Floor Research Center - 50 North Dunlap St, Memphis, TN 38103 | 2020-04-01 |
| 1962030221 | Allison Burge Clayton | Dietitian, Registered | 50 N Dunlap, Nutrition Therapy Dept, 1st Floor Research Tower, Memphis, TN 38103 | 2020-03-31 |
| 1093375420 | Radar Ems, LLC | Social Worker | 50 S. B.b. King Blvd, Suite 350, Memphis, TN 38103 | 2019-06-18 |
| 1528529021 | Denise Andrews Matthews | Nursing Care | 342 Island Dr #105, Memphis, TN 38103 | 2019-03-27 |
| 1881160059 | Christopher Paul Hernandez | Nurse Practitioner | 877 Jeffeon Ave, Memphis, TN 38103 | 2018-10-15 |
| 1194245712 | Cameron Waters Clinard | Optometrist | 127 Isle Creek Dr, Memphis, TN 38103 | 2017-06-24 |
| 1750732582 | Amanda Leigh Eaves | Nurse Practitioner | 364 S Front St Ste 201, Memphis, TN 38103 | 2016-06-22 |
| 1417304569 | John Clark Shell | Family Medicine | 150 Harbor Creek Dr, Memphis, TN 38103 | 2016-05-18 |
| 1750753695 | Tomisha V. Byard | Nurse Practitioner | 718 Habor Bend Road, Memphis, TN 38103 | 2015-10-29 |
| 1053795179 | Melissa Anne Wilkes | Social Worker | 1240 Harbor River Drive, Memphis, TN 38103 | 2015-07-18 |
| Find all providers in zip 38103 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770963746 | Ayman Al Dayeh | Dentist | 875 Union Ave, S312, Department of Orthodontics, Memphis, TN 38163 | 2015-06-04 |
| 1184869638 | Stanley Patrick Werner | Dentist | 6425 Quail Hollow Rd, Suite 201, Memphis, TN 38120 | 2008-12-12 |
| 1780722959 | Walter Cooper Sandusky IIi | Dentist | 6262 Poplar Ave, Memphis, TN 38119-4728 | 2007-02-01 |
| 1861557555 | Werner Orthodontics PC | Dentist | 6425 N Quail Hollow Rd, Suite 201, Memphis, TN 38120-1437 | 2006-12-25 |
| 1881777126 | Danny Weiss | Dentist | 5885 Ridgeway Center Pkwy, Suite 200, Memphis, TN 38120-4055 | 2006-10-23 |
| 1134214828 | Joe Lawrence Wasson | Dentist | 5575 Poplar Ave Ste 218, Memphis, TN 38119-3851 | 2006-10-04 |
| 1942224233 | James P Wiygul | Dentist | 5340 Poplar Ave, Suite #1, Memphis, TN 38119-3516 | 2006-07-27 |
| 1518956945 | Samuel L Watts | Dentist | 5101 Sanderlin Ave, Suite 108, Memphis, TN 38117-4362 | 2005-10-18 |
| 1609351832 | Jared Moffett | Dentist | 875 Union Ave, Memphis, TN 38103-3513 | 2018-10-03 |
| 1427420561 | University of Tennessee | Dentist | 875 Union Ave., Suite C303, Memphis, TN 38103-3513 | 2015-10-28 |
| 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.