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NPI Code Detail

MEDICARE: HIGHLAND PARK DENTAL CENTER, PC

MEDICARE: HIGHLAND PARK DENTAL CENTER, PC
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
11223G0001XGeneral Practice DentistryDS3559TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215935614
Entity Type Code : Organization
Provider Name (Legal Business Name) : HIGHLAND PARK DENTAL CENTER, PC
Provider Business Mailing Address
First Line : 845 S HIGHLAND ST
Second Line :
City : MEMPHIS
State : TN
Zip : 38111-4254
Country : US
Telephone Number : 901-323-8488
Fax Number : 901-323-8489
Provider Business Practice Location Address
First Line : 845 S HIGHLAND ST
Second Line :
City : MEMPHIS
State : TN
Zip : 38111-4254
Country : US
Telephone Number : 901-323-8488
Fax Number : 901-323-8489
Authorized Official
Title or Position : PRESIDENT
Name : DR. SHARAD S CHITALIA
Credential : D.D.S.
Telephone Number : 901-323-8444
Provider Enumeration Date : 07/09/2005
Last Update Date : 08/22/2020

Similar Medicare Providers

1851420228 — DR. NANCY B MASSEY D.D.S.
Practice Location Address:
845 S HIGHLAND ST
MEMPHIS, TN
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Practice Fax: 901-323-9489
1033321559 — DR. SHARAD CHITALIA D.D.S.
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1750580429 — DR. PRANAV D. DESAI D.D.S.
Practice Location Address:
845 S HIGHLAND ST
MEMPHIS, TN
38111-4254
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Practice Fax: 901-323-8489
1720216880 — DR. EUNJUNG EDWARDS DDS
Practice Location Address:
845 S HIGHLAND ST
MEMPHIS, TN
38111-4254
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1114299401 — FAMILY AND COSMETIC DENTISTRY OF MEMPHIS, PLLC
Practice Location Address:
845 S HIGHLAND ST
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Practice Fax:
1245107200 — MEMPHIS FAMILY AND COSMETIC DENTISTRY
Practice Location Address:
845 S HIGHLAND ST
MEMPHIS, TN
38111-4254
Practice Phone: 307-315-7301
Practice Fax:

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