Provider Demographics
NPI:1659644524
Name:MCCANN, BILLY WESTMORELAND SR (DDS)
Entity type:Individual
Prefix:DR
First Name:BILLY
Middle Name:WESTMORELAND
Last Name:MCCANN
Suffix:SR
Gender:M
Credentials:DDS
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:PEDIATRIC DENTISTRY DEPT
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-3513
Mailing Address - Country:US
Mailing Address - Phone:901-448-6206
Mailing Address - Fax:
Practice Address - Street 1:875 UNION AVE
Practice Address - Street 2:PEDIATRIC DENTISTRY DEPT
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-3513
Practice Address - Country:US
Practice Address - Phone:901-448-6206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS11001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN626001636OtherUNIVERSITY OF TENNESSE COLLEGE OF DENTISTRY