Jacob Perry, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12623 Issued in TN

Practice address

4972 Highway 58 Ste 114
Chattanooga, TN 37416-1868

Phone

(423) 894-5223

NPI assigned

Sep 16, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Professional Dental Alliance of Tennessee, PLLC

  • General Practice Dentistry
  • Chattanooga, TN
  • NPI 1730725953
  NPD

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1346077260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4972 HIGHWAY 58 STE 114",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374161868",
            "telephone_number": "423-894-5223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4972 HIGHWAY 58 STE 114",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374161868",
            "telephone_number": "423-894-5223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "JACOB",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "12623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Christopher Perry, DDS
• Bruce Duncan Perry
• Elizabeth T Perry, DNP
• Ethan Jack Perry
• Gershon Y Perry, M.D., F.A.C.C
• Jeffrey Wayne Perry, PHARM.D.
• Katharine Perry, LMSW
• Kiley Perry
• Lee Michael Perry, M.D.
• Matthew Wade Perry, PHARMD, MM

• General Practice Dentistry in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.