MEDICARE: WATKINS FAMILY DENTISTRY

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	122300000X	Dentist

General Provider Information

NPI Number	:	1659234805
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WATKINS FAMILY DENTISTRY

Provider Business Mailing Address
First Line	:	3912 ELVIS PRESLEY BLVD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38116-5628
Country	:	US
Telephone Number	:	901-398-8216
Fax Number	:	901-398-6000

Provider Business Practice Location Address
First Line	:	3912 ELVIS PRESLEY BLVD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38116-5628
Country	:	US
Telephone Number	:	901-398-8216
Fax Number	:	901-398-6000

Authorized Official
Title or Position	:	DENTIST/OWNER
Name	:	DR. MALIKA WATKINS
Credential	:	DDS
Telephone Number	:	901-830-9159

Provider Enumeration Date	:	12/04/2025
Last Update Date	:	12/04/2025

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