NPIMap

Organization Active NPI

Chattanooga Periodontics & Dental Implants, PC

  • Periodontics
  • Chattanooga, TN
National Provider Identifier
1063562460
Registry record updated Feb 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DS3107 Issued in TN
Legal business name
CHATTANOOGA PERIODONTICS & DENTAL IMPLANTS, PC
Practice address
951 Riverfront Pkwy
Ste 102
Chattanooga, TN 37402-2185
Phone
(423) 756-2450
Fax
(423) 756-5451
NPI assigned
Jan 10, 2007
Last updated
Feb 28, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2017

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

Authorized official

Name
Dr. Charles Baker Felts III, D.D.S., M.S.DNPI 1386640704
Title
President
Phone
(423) 756-2450

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X DS3107 TN Primary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X DS9462 TN

Addresses

Primary practice location

951 Riverfront Pkwy
Ste 102
Chattanooga, TN 37402-2185

Mailing address

951 Riverfront Pkwy
Ste 102
Chattanooga, TN 37402-2185
Phone (423) 756-2450

National Provider Directory

National Provider Directory

Locations

951 Riverfront Pkwy
Ste 102
Chattanooga, TN 37402
Phone (423) 756-2450

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488240000000",
    "number": "1063562460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 RIVERFRONT PKWY",
            "address_2": "STE 102",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374022185",
            "telephone_number": "423-756-2450",
            "fax_number": "423-756-5451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 RIVERFRONT PKWY",
            "address_2": "STE 102",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374022185",
            "telephone_number": "423-756-2450",
            "fax_number": "423-756-5451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHATTANOOGA PERIODONTICS & DENTAL IMPLANTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2017-02-28",
        "status": "A",
        "authorized_official_last_name": "FELTS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "BAKER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-756-2450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.D.S., M.S.D"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "TN",
            "license": "DS3107",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "TN",
            "license": "DS9462",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; 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.