# CHICKASAW DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619005717
- **Authorized official:** ORPHEUS TRIPLETT DDS (PRESIDENT)
- **Authorized official phone:** (901) 324-0093

## Contact information

- **Practice address:** 2877 POPLAR AVE, MEMPHIS, TN 38111-2023
- **Practice address phone:** (901) 324-0093
- **Practice address fax:** (901) 324-4029
- **Mailing address:** 2877 POPLAR AVE, MEMPHIS, TN 38111-2023
- **Mailing address phone:** (901) 324-0093
- **Mailing address fax:** (901) 324-4029

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 4439 | TN | Yes |

## Other

- **Enumeration date:** 03/01/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3225499 | — | TN |