Provider Demographics
NPI:1639245111
Name:LLOYD, ADAM (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:LLOYD
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38163-0001
Mailing Address - Country:US
Mailing Address - Phone:901-448-1731
Mailing Address - Fax:901-448-1799
Practice Address - Street 1:8747 NORTHWEST DR
Practice Address - Street 2:
Practice Address - City:SOUTHHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-2409
Practice Address - Country:US
Practice Address - Phone:662-382-9988
Practice Address - Fax:901-448-1799
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4661223E0200X
MSENDO-600-211223E0200X
MS4220-21122300000X
TNTN90761223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223E0200XDental ProvidersDentistEndodontics