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General NPI Number Information
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NPI Number | 1639043987
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Entity Type | Organization
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Legal Business Name | DENTAL EXCELLENCE MEMPHIS PLLC
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Dates
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Enumeration Date | 09/30/2025
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 5180 PARK AVE STE 310
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City | MEMPHIS
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State | TN
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Zip | 38119-3531
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Country | US
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Telephone | 901-685-1152
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Fax |
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Provider Business Mailing Address
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Address Line | 15660 DALLAS PKWY STE 950
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City | DALLAS
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State | TX
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Zip | 75248-3309
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Country | US
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Telephone | 214-702-0708
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, PAYER RELATIONS
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Name | AMANDA LIGHTFOOT
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Credential |
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Telephone | 214-702-0708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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