Healthcare Provider Details

I. General information

NPI: 1255256236
Provider Name (Legal Business Name): DEJA AIRELL REED DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2953 BROAD AVE
MEMPHIS TN
38112-2957
US

IV. Provider business mailing address

1718 DAVID DR
MEMPHIS TN
38116-5714
US

V. Phone/Fax

Practice location:
  • Phone: 901-842-1894
  • Fax:
Mailing address:
  • Phone: 901-598-0213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number13315
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: