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MACK ENDODONTICS DDS P.C. NPI 1558659516


NPI Information

NPI: 1558659516
Provider Name: MACK ENDODONTICS DDS P.C.
Classification: Dentist - 1223E0200X
Entity Type: Organization

Specialization: Endodontics

Address:
5180 PARK AVE STE 300
MEMPHIS, TN
ZIP 38119
Phone: (901) 683-2221
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MACK ENDODONTICS DDS P.C. is an endodontics dentist in Memphis, TN. The provider is the branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. MACK ENDODONTICS DDS P.C. NPI is 1558659516. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5180 PARK AVE STE 300
MEMPHIS, TN
ZIP 38119-531
Phone: (901) 683-2221
Fax: (901) 683-2882

The provider's authorized official is Edward M Mack .
The authorized official title is Owner/dentist and has the following contact phone number (901) 683-2221.

The enumeration date for this NPI number is 7/12/2011 and was last updated on 7/12/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223E0200XDentistEndodontics7948TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15441030MEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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