LARRY D DORMOIS D.D.S M.S. NPI 1386700839

NPI Information

NPI: 1386700839
Provider Name: LARRY D DORMOIS, D.D.S, M.S.
Classification: Dentist - 1223P0221X
Entity Type: Individual

Specialization: Pediatric Dentistry

Address:
875 UNION AVE
MEMPHIS, TN
ZIP 38103
Phone: (901) 448-6240
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Larry D Dormois, D.D.S, M.S. is a pediatric dentistry dentist in Memphis, TN. The provider is 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. Larry D Dormois, D.D.S, M.S. NPI is 1386700839. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

875 UNION AVE
MEMPHIS, TN
ZIP 38103
Phone: (901) 448-6240

The enumeration date for this NPI number is 12/29/2006 and was last updated on 8/27/2019.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223P0221X	Dentist	Pediatric Dentistry	2335	MISSISSIPPI	No
2	1223P0221X	Dentist	Pediatric Dentistry	3545	TENNESSEE	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	109831608	MEDICAID	ARKANSAS
2	4031775	OTHER	TENNESSEE	BCBS TN PROVIDER
3	6049	MEDICAID	TENNESSEE

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

NPI Synchronization or Removal

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