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General NPI Number Information
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NPI Number | 1265321350
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Entity Type | Individual
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Provider Name | JUSTIN BIAM DDS
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Gender | Male
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 3030 COVINGTON PIKE STE 150
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City | MEMPHIS
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State | TN
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Zip | 38128-5041
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Country | US
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Telephone | 901-310-1441
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Fax |
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Provider Business Mailing Address
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Address Line | 1546 MADISON AVE APT 308
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City | MEMPHIS
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State | TN
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Zip | 38104-2884
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Country | US
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Telephone | 901-336-5372
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12937
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License Number State | TN
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