SOUTHSIDE DENTAL ARTS, LLC (NPI# 1538456199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538456199 |
| Entity Type | Organization |
| Organization Name | SOUTHSIDE DENTAL ARTS, LLC |
| Other Organization Name | SMILE STUDIO ORTHODONTICS |
| Practice Address |
200 W Main St Chattanooga TN 37408-1136 |
| Practice Telephone | 4232656685 |
| Practice Fax Number | 4232658206 |
| Mailing Telephone | 4232656685 |
| Mailing Fax Number | 4232658206 |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2012-12-31 |
| Authorized Official Name | DR. GEORGE MITCHELL BALDREE (ORGANIZER/MANAGING MEMBER) |
| Authorized Official Telephone | 4232656685 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
DS005163 | TN | Dental Providers |
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
DS005096 | TN | Dental Providers |
| Other Name | Type Code |
|---|---|
| Smile Studio Orthodontics | Doing Business As Name - Organization |
| Street Address |
200 W MAIN ST |
| City | CHATTANOOGA |
| State | TN |
| Zip Code | 37408-1136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548343189 | George Mitchell Baldree | Dentist | 200 W Main St, Chattanooga, TN 37408-1136 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043766975 | Athletic Edge Physical Therapy | Clinic/Center | 1440 Adams St Ste A, Chattanooga, TN 37408 | 2016-08-31 |
| 1609287689 | Access 2 Rehab | Physical Therapist | 612 East 11th Street, Chattanooga, TN 37408 | 2014-05-13 |
| 1366873853 | Holli Richey | Social Worker | 320 E. Main St., Suite 200, Chattanooga, TN 37408 | 2013-12-09 |
| 1427397900 | Bevin Gracy | Counselor | 3069 Broad St Ste 7d, Chattanooga, TN 37408 | 2013-02-04 |
| 1932450756 | Tiffany Allen Hobbs | Registered Nurse | 1800 Rossville Avenue, Suite 114, Chattanooga, TN 37408 | 2012-09-20 |
| 1467708594 | Ctr. for Individ. & Family Effectiveness | Community/Behavioral Health | 2441 Broad St., Ste. 150, Chattanooga, TN 37408 | 2012-07-26 |
| 1538431192 | Brandon Tyler Whitworth | Physical Therapist | 1440 Adams St, Chattanooga, TN 37408 | 2012-01-29 |
| 1699059550 | David Jamison Mcdowell | Psychologist | 3097 S. Broad St., Chattanooga, TN 37408 | 2011-10-10 |
| 1093918385 | Jason L Reich | Counselor | 320 E Main Street, Suite 200, Chattanooga, TN 37408 | 2007-06-06 |
| 1063636785 | Carol Burns Stoney | Counselor | 3085 South Broad St, Suite J, Chattanooga, TN 37408 | 2007-04-12 |
| Find all providers in zip 37408 | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275659310 | Michelle Fincher Ireland | Dentist | 6120 Shallowford Rd, Ste.108, Chattanooga, TN 37421-7215 | 2007-03-21 |
| 1548343189 | George Mitchell Baldree | Dentist | 200 W Main St, Chattanooga, TN 37408-1136 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598311573 | Restoration Dentistry | Dentist | 1984 Providence Pkwy Ste 200, Mt Juliet, TN 37122-4459 | 2019-08-14 |
| 1114304524 | Nicholas G Norvell | Dentist | 1984 Providence Pkwy #200, Mount Juliet, TN 37122 | 2015-05-05 |
| 1972703387 | Louis Bonvissuto | Dentist | 4731 Trousdale Dr Ste 8, Nashville, TN 37220-1383 | 2007-07-23 |
| 1033328448 | Joshua Heath Balch | Dentist | 1801 W End Ave Ste 1100, Nashville, TN 37203-2516 | 2007-05-22 |
| 1245374271 | Marc A. Cohen | Dentist | 5356 Estate Office Dr, Suite 1, Memphis, TN 38119-3664 | 2007-02-15 |
| 1013085240 | Robert P Dziejma | Dentist | 7105 Bakers Bridge Ave, #400, Brentwood, TN 37027 | 2006-12-04 |
| 1992871388 | William Rayford Priester IIi | Dentist | 5866 Ridge Bend Rd, Suite 1, Memphis, TN 38120-9477 | 2006-11-28 |
| 1750469953 | Michael A Smith | Dentist | 6244 Poplar Ave, Memphis, TN 38119-4732 | 2006-11-02 |
| 1396820312 | Felix Springfield | Dentist | 780 Ridge Lake Blvd Ste 201, Memphis, TN 38120-9426 | 2006-10-26 |
| 1154415388 | Ronald Peter Lubovich | Dentist | 2828 Bransford Ave, Nashville, TN 37204-3102 | 2006-10-03 |
| Find all providers with the same taxonomy | ||||
| City | CHATTANOOGA |
| Zip Code | 37408 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.