Facial Dental Center, P.C.

Primary specialty

DentistTaxonomy code 122300000X

License

DS9121 Issued in TN

Legal business name

FACIAL DENTAL CENTER, P.C.

Practice address

1720 Gunbarrel Rd Ste 310
Chattanooga, TN 37421-3192

Phone

(423) 602-8642

NPI assigned

Feb 11, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Jenny V. Nunez, DDS

Title

President/Dentist

Phone

(423) 827-2770

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Just4teens Former legal business name

Locations

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

{
    "created_epoch": "1455148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455148800000",
    "number": "1376902809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 GUNBARREL RD STE 310",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374213192",
            "telephone_number": "423-602-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 GUNBARREL RD STE 310",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374213192",
            "telephone_number": "423-602-8642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACIAL DENTAL CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-11",
        "last_updated": "2016-02-11",
        "status": "A",
        "authorized_official_last_name": "NUNEZ",
        "authorized_official_first_name": "JENNY",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "PRESIDENT/DENTIST",
        "authorized_official_telephone_number": "423-827-2770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TN",
            "license": "DS9121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q017535",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Just4teens",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Eye Surgery Center of Chattanooga, LLC
• Terrance M Eyerly Jr., DC
• Kori N Eytcheson, MPT
• Richard Stephen Ezell, R.PH.
• Elizabeth Ezzell
• Leigh B. Faerber, RN, CNM
• Dina Fahmy, DC
• Chelsea R Fain
• Taryn E. Fairbanks, CRNA
• Christopher Fairchild

• 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 Feb 11, 2016; 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.