MEDICARE: DELLWYN TURNIPSEED D.M. D.,P. C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0105595	OTHER	TN	BCBS

General Provider Information

NPI Number	:	1033244595
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DELLWYN TURNIPSEED D.M. D.,P. C.

Provider Business Mailing Address
First Line	:	P. O. BOX 1000 DEPT 397
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38148
Country	:	US
Telephone Number	:	901-722-8445
Fax Number	:	901-722-2425

Provider Business Practice Location Address
First Line	:	1195 POPLAR AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38105-4807
Country	:	US
Telephone Number	:	901-722-8445
Fax Number	:	901-722-2425

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. DELLWYN TURNIPSEED
Credential	:	D.M.D
Telephone Number	:	901-722-8445

Provider Enumeration Date	:	02/23/2007
Last Update Date	:	08/22/2020

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