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General NPI Number Information
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NPI Number | 1952512659
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Entity Type | Individual
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Provider Name | JOHN BRISBY LOTT SR. D.D.S
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Gender | Male
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 02/08/2026
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Provider Practice Location Address
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Address Line | 1297 MARLIN RD 771 EAST MALLORY AVENUE
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City | MEMPHIS
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State | TN
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Zip | 38116-5814
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Country | US
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Telephone | 901-396-6753
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Fax | 901-346-7772
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Provider Business Mailing Address
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Address Line | 1297 MARLIN RD 771 EAST MALLORY AVENUE
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City | MEMPHIS
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State | TN
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Zip | 38116-5814
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Country | US
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Telephone | 901-396-6753
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Fax | 901-346-7772
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS005074
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License Number State | TN
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