NPIMap

Organization Active NPI

Gustavo Moretta Dentistry, PLLC

  • Dental Clinic/Center
  • Hixson, TN
National Provider Identifier
1104621820
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
GUSTAVO MORETTA DENTISTRY, PLLC
Doing business as
Big Ridge Family and Cosmetic Dentistry
Brush House Dental
Practice address
5606 Highway 153
Hixson, TN 37343-3725
Phone
(423) 877-1334
Fax
(423) 877-1334
NPI assigned
Feb 17, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Authorized official

Name
Dr. Gustavo Daniel Moretta, DDSNPI 1598544025
Title
Owner
Phone
(423) 877-1334

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

5606 Highway 153
Hixson, TN 37343-3725

Mailing address

5606 Highway 153
Hixson, TN 37343-3725
Phone (423) 877-1334

Other names 2

  • Big Ridge Family and Cosmetic Dentistry Doing business as
  • Brush House Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1739750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739750400000",
    "number": "1104621820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5606 HIGHWAY 153",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373433725",
            "telephone_number": "423-877-1334",
            "fax_number": "423-877-1334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5606 HIGHWAY 153",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373433725",
            "telephone_number": "423-877-1334",
            "fax_number": "423-877-1334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUSTAVO MORETTA DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-17",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A",
        "authorized_official_last_name": "MORETTA",
        "authorized_official_first_name": "GUSTAVO",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-877-1334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Big Ridge Family and Cosmetic Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brush House Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hixson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.