# DENTALWORKS, DR. DIETZ & ASSOCIATES (AUSTIN PEAY), P.C.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DENTALONE PARTNERS, INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1407826902
- **Legal business name:** DENTALONE PARTNERS, INC
- **Authorized official:** DR. JAMES G DIETZ JR. DMD (DENTIST/OWNER)
- **Authorized official phone:** (901) 373-3894

## Contact information

- **Practice address:** 3890 AUSTIN PEAY HWY, MEMPHIS, TN 38128-2501
- **Practice address phone:** (901) 373-3894
- **Practice address fax:** (216) 584-1201
- **Mailing address:** PO BOX 860036, MINNEAPOLIS, MN 55486-0036
- **Mailing address phone:** (901) 373-3894
- **Mailing address fax:** (216) 584-1201

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | — |
| 122300000X | Dentist | — | — | — |
| 1223E0200X | Endodontics | — | NULL | — |
| 1223E0200X | Endodontics | — | — | — |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 1223P0221X | Pediatric Dentistry | — | NULL | — |
| 1223P0221X | Pediatric Dentistry | — | — | — |
| 1223P0300X | Periodontics | — | NULL | — |
| 1223P0300X | Periodontics | — | — | — |
| 1223P0700X | Prosthodontics | — | NULL | — |
| 1223P0700X | Prosthodontics | — | — | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | NULL | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | — | — |

## Other

- **Enumeration date:** 01/25/2006
- **Last updated:** 05/04/2015