Legacy Dental Group, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

LEGACY DENTAL GROUP, PLLC

Practice address

1605 Williams Rd
Hixson, TN 37343-4934

Phone

(423) 843-0418

Fax

(423) 842-7362

NPI assigned

Sep 18, 2023

Organization subpart

No

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

Authorized official

Name

Marcy Kay

Title

Insurance Administrator

Phone

(423) 843-0418

Specialties & licenses 1

Addresses

Other names 3

• Dr. Andrew Lunn, DDS Doing business as
• Hixson Dental Groujp Doing business as
• Mountain View Family Dental Doing business as

Locations

Practitioners 5

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

• Jesse Steven Pollom, DDS

  • General Practice Dentistry
  • Hixson, TN
  • NPI 1013526946
  NPD
• Austin Worley Toler, DMD

  • General Practice Dentistry
  • Hixson, TN
  • NPI 1881439529
  NPD
• Sydney Wingfield, DDS

  • Dentist
  • Hixson, TN
  • NPI 1912891631
  NPD
• Andrew Riley Lunn, DDS

  • General Practice Dentistry
  • Chattanooga, TN
  • NPI 1326051764
  NPD (past)
• Frederick H Thompson, DDS

  • General Practice Dentistry
  • Chattanooga, TN
  • NPI 1447508098
  NPD (past)

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694995200000",
    "number": "1487432811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 WILLIAMS RD",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373434934",
            "telephone_number": "423-843-0418",
            "fax_number": "423-842-7362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 WILLIAMS RD",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373434934",
            "telephone_number": "423-843-0418",
            "fax_number": "423-842-7362"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4109 Mountain View Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374152096",
            "country_code": "US",
            "telephone_number": "423-875-5661",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1606 Gunbarrel Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374217196",
            "country_code": "US",
            "telephone_number": "423-553-8858",
            "fax_number": "423-553-8865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LEGACY DENTAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A",
        "authorized_official_last_name": "KAY",
        "authorized_official_first_name": "MARCY",
        "authorized_official_title_or_position": "INSURANCE ADMINISTRATOR",
        "authorized_official_telephone_number": "423-843-0418"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Andrew Lunn, DDS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hixson Dental Groujp",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mountain View Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stewart Lawwill III, DDS
• Michael Allen Leazer, DPH
• Kimberly Dawn Ledbetter, PTA
• Sasha Ledezma
• Hope Victoria Ledger, APRN, FNP-BC
• Margaret Ellen Leighty
• Michael Owen Levan, DPH
• Caroline Lewis
• Raymond David Lewis, DPH
• William Freeman Lewis, FNP-C

• General Practice Dentistry in Hixson, TN
• Providers in Hixson, 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 18, 2023; 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.