DR. GARY MARTIN EDGMON (NPI# 1548332166) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548332166 |
| Entity Type | Individual |
| Full Name | DR. GARY MARTIN EDGMON |
| Credential | DDS MS |
| Practice Address |
7003 Shallowford Rd Ste 201 Chattanooga TN 37421 |
| Mailing Address |
7003 Shallowford Rd Ste 201 Chattanooga TN 37421-6722 |
| Practice Telephone | 4235411850 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2019-03-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
10198 | TN | Dental Providers |
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
09156 | GA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q046284 | 05 | |
| TN | Q045942 | 05 | |
| TN | 1376027862 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7003 Shallowford Rd Ste 201, Chattanooga, TN 37421 | 4235411850 |
| Street Address |
7003 SHALLOWFORD RD STE 201 |
| City | CHATTANOOGA |
| State | TN |
| Zip Code | 37421 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376027862 | Affordable Smiles Pllc | Dentist | 7003 Shallowford Rd Ste 201, Chattanooga, TN 37421-6722 | 2018-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558991588 | Janera Pentiah | Physician Assistant | 1360 Mackey Branch Dr, Chattanooga, TN 37421 | 2020-01-17 |
| 1750921367 | Stephan Ian Belasco | Counselor | 1360 Mackey Branch Dr., Chattanooga, TN 37421 | 2020-01-11 |
| 1932745817 | Sound Living Inc | Community/Behavioral Health | 6727 Heritage Business Court, Suite 720, Chattanooga, TN 37421 | 2019-11-26 |
| 1245875046 | Chattanooga Compounding Pharmacy Inc. | Pharmacy | 7032 East Brainerd Rd, Suite A-b, Chattanooga, TN 37421 | 2019-11-15 |
| 1083105803 | Trauma and Addiction Recovery Center | Counselor | 6727 Heritage Business Ct Ste 718, Chattanooga, TN 37421 | 2018-05-29 |
| 1497257448 | Claude James Bowden | Counselor | 7372 Applegate Lane, Chattanooga, TN 37421 | 2018-03-06 |
| 1093213332 | Preferred Primary Care | Clinic/Center | 6031 Shallowford Rd Ste 105, Chattanooga, TN 37421 | 2018-01-31 |
| 1124526777 | Elizabeth Marie Wright | Nurse Practitioner | 6130 Shallowford Rd Ste 101, Chattanooga, TN 37421 | 2018-01-30 |
| 1477065712 | Publix Tennessee LLC | Durable Medical Equipment & Medical Supplies | 7326 Mccutcheon Rd, Chattanooga, TN 37421 | 2017-10-26 |
| 1144746645 | Mobility At Home LLC | Contractor | 6307 E Brainerd Rd, Chattanooga, TN 37421 | 2017-08-16 |
| Find all providers in zip 37421 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568996999 | Jefferson Twomley | Dentist | 1414 Jenkins Rd Ste 146, Chattanooga, TN 37421-3470 | 2017-04-12 |
| 1982819991 | Daniel C Sawrie | Dentist | 1612 Gunbarrel Rd Ste 100, Chattanooga, TN 37421-4135 | 2007-05-12 |
| 1992830418 | Stephen Malone Sawrie | Dentist | 4727 Brainerd Rd, Chattanooga, TN 37411-3828 | 2007-02-23 |
| 1619064391 | Dwayne B. Mccamish Dds Ms PC | Dentist | 4610 Brainerd Road, Chattanooga, TN 37411 | 2006-10-06 |
| 1033123344 | Keith B Dressler | Dentist | 6820 Lee Hwy, Chattanooga, TN 37421-2444 | 2006-07-29 |
| 1376027862 | Affordable Smiles Pllc | Dentist | 7003 Shallowford Rd Ste 201, Chattanooga, TN 37421-6722 | 2018-09-20 |
| 1467992149 | Greater Chattanooga Orthodontics | Dentist | 1829 Gunbarrel Rd, Ste. B, Chattanooga, TN 37421-7184 | 2017-03-01 |
| 1548626047 | Greater Chattanooga Orthodontics, Pllc | Dentist | 1829 Gunbarrel Rd, Suite A, Chattanooga, TN 37421-7184 | 2016-01-13 |
| 1578948683 | James E. Larson Dds, Msd | Dentist | 1829 Gunbarrel Rd, Suite A, Chattanooga, TN 37421-7184 | 2015-07-30 |
| 1538456199 | Southside Dental Arts, LLC | Dentist | 200 W Main St, Chattanooga, TN 37408-1136 | 2011-07-05 |
| Find all providers in CHATTANOOGA | ||||
| City | CHATTANOOGA |
| Zip Code | 37421 |
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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.