Provider Demographics
NPI:1811048440
Name:DOWNEY, JOHN CHRISTIAN (DDS)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:CHRISTIAN
Last Name:DOWNEY
Suffix:
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 1:1896 CRUMP AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38107-4617
Mailing Address - Country:US
Mailing Address - Phone:734-754-1824
Mailing Address - Fax:
Practice Address - Street 1:700 S MENDENHALL RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-5213
Practice Address - Country:US
Practice Address - Phone:734-754-1824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN117241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4767338Medicaid
MI4767347Medicaid