MEDICARE: DR. JON CARL STANFORD D.D.S.

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	DS003629	TN

General Provider Information

NPI Number	:	1184701310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JON CARL STANFORD D.D.S.

Provider Business Mailing Address
First Line	:	3596 PARK AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38111-5622
Country	:	US
Telephone Number	:	901-458-2617
Fax Number	:

Provider Business Practice Location Address
First Line	:	3596 PARK AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38111-5622
Country	:	US
Telephone Number	:	901-458-2617
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	10/23/2014

Similar Medicare Providers

1306517743 — DR. JACOB CHARLES JOHNSON PHARMD
Practice Location Address:

3502 PARK AVE
MEMPHIS, TN
38111-5622

Practice Phone: 901-324-1050
Practice Fax:

1427905488 — ALEXANDRIA HARBER PT,DPT
Practice Location Address:

3398 NORTHWOOD DR
MEMPHIS, TN
38111-4706

Practice Phone: 901-238-8455
Practice Fax:

1518814458 — AMBER D EVANS RN
Practice Location Address:

87 N GREER ST
MEMPHIS, TN
38111-3601

Practice Phone: 901-461-2631
Practice Fax:

1225981053 — JAMIE CAMILLA PURSELL FNP
Practice Location Address:

3720 ALUMNI AVE
MEMPHIS, TN
38111-5914

Practice Phone: 901-678-2000
Practice Fax:

1326932401 — A PLUS THERAPY SERVICES LLC
Practice Location Address:

3599 VANUYS RD STE 100
MEMPHIS, TN
38111-5649

Practice Phone: 901-609-4342
Practice Fax:

1639172653 — MOMENTUM PHYSICAL REHABILITATION, LLC
Practice Location Address:

80 S PRESCOTT ST
MEMPHIS, TN
38111-4635

Practice Phone: 901-257-3422
Practice Fax: 901-257-3423

Directions to “ DR. JON CARL STANFORD D.D.S.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.