St Elmo Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ST ELMO DENTAL LLC

Practice address

3918 Tennessee Ave Ste 300
Chattanooga, TN 37409-1352

Phone

(423) 821-7711

NPI assigned

Dec 1, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Taylor Lawson

Title

Office Manager

Phone

(423) 821-9771

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701388800000",
    "number": "1003682873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3918 TENNESSEE AVE STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374091352",
            "telephone_number": "423-821-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3918 TENNESSEE AVE STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374091352",
            "telephone_number": "423-821-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ELMO DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-01",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A",
        "authorized_official_last_name": "LAWSON",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "423-821-9771"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry Richard Sprouse II, M.D.
• Rachael Addison Spruell, NP
• John A Spruill, CRNA
• Jennifer R. Spry, PA-C
• St Barnabas Apartments Assisted Living Inc
• Matthew Wyatt St Hilaire
• St Joseph Clinic, P.C.
• St. Elmo Dental
• Carolyn St. John, CCC-SLP
• Rebekah Staats, LMSW

• Dental Clinic/Center in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Dental Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.