Individual provider Active NPI

Angela Garner Lunn, DDS

  • Dentist
  • Chattanooga, TN
National Provider Identifier
1043430648
Registry record updated Mar 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4709 Issued in TN
Practice address
5323 Brainerd Road
Suite 106
Chattanooga, TN 37411
Phone
(423) 892-5137
Fax
(423) 490-0791
NPI assigned
Apr 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4709 TN Primary

Addresses

Primary practice location

5323 Brainerd Road
Suite 106
Chattanooga, TN 37411

Mailing address

5323 Brainerd Road
Suite 106
Chattanooga, TN 37411
Phone (423) 892-5137

Other identifiers 3

IdentifierTypeStateIssuer
0003091SCOtherSCDELTA DENTAL OF MISSOURI
570922234OtherSCBCBS
Z30912MedicaidSC

Other names 1

  • Angela Garner Wilson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230111003039 TN Order and Referring Only - DentistPractitioner - Dentist 7719131010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4709TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Riley H Lunn DDS PLLC Dentist CurrentSince May 5, 2008 Accepting new patients
Chattanooga Sleep & TMJ Associates at Lunn Dentistry PLLC Past Accepting new patients

Locations

5323 Brainerd Rd
Ste 106
Chattanooga, TN 37411
Phone (423) 892-5137

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363305600000",
    "number": "1043430648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5323 BRAINERD ROAD",
            "address_2": "SUITE 106",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37411",
            "telephone_number": "423-892-5137",
            "fax_number": "423-490-0791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 BRAINERD ROAD",
            "address_2": "SUITE 106",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37411",
            "telephone_number": "423-892-5137",
            "fax_number": "423-490-0791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNN",
        "first_name": "ANGELA",
        "middle_name": "GARNER",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2013-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "4709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL OF MISSOURI",
            "identifier": "0003091SC",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "570922234",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z30912",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "WILSON",
            "middle_name": "GARNER",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.