Brad W Sundstrom DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D57688 Issued in TN

Legal business name

BRAD W SUNDSTROM DMD

Practice address

7044 Lee Hwy
Chattanooga, TN 37421-1730

Phone

(423) 894-0650

Fax

(423) 894-0720

NPI assigned

Feb 5, 2007

Last updated

Oct 30, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Bradley Walker Sundstrom, DMD

Title

Owner

Phone

(423) 894-0650

Specialties & licenses 2

Addresses

Other names 1

• Chattanooga Dental Center Other name

Locations

Practitioners 1

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.

• Brad W Sundstrom, DMD

  • Dentist
  • Chattanooga, TN
  • NPI 1356576920
  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225324800000",
    "number": "1184762684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7044 LEE HWY",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211730",
            "telephone_number": "423-894-0650",
            "fax_number": "423-894-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7044 LEE HWY",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211730",
            "telephone_number": "423-894-0650",
            "fax_number": "423-894-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAD W SUNDSTROM DMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2008-10-30",
        "status": "A",
        "authorized_official_last_name": "SUNDSTROM",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "WALKER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-894-0650",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TN",
            "license": "D57688",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TN",
            "license": "D53493",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chattanooga Dental Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Twyler Boykin
• Michael B Bozzone, D.C.
• Janna Brackett, LCSW
• Richard W Brackett, MD
• Ronald David Brackett, PT
• Paula Braden
• Elizabeth Rushworth Bradford, DPT
• Jennifer Lacie Bradford, PHARMD
• Megan E Bradford, CRNA
• Wesley Drennon Bradford, PHARMD

• Dentist in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Dentist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2008; 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.