Organization Active NPI

Luna Dental Spa

  • Dentist
  • Ooltewah, TN
National Provider Identifier
1538091905
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
LUNA DENTAL SPA
Practice address
9203 Lee Hwy Ste 16
Ooltewah, TN 37363-6459
Phone
(423) 414-3632
NPI assigned
Jun 1, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Authorized official

Name
Ruchi Mukesh Patel, DMDNPI 1750951885
Title
Owner Dentist
Phone
(423) 310-0075

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
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

9203 Lee Hwy Ste 16
Ooltewah, TN 37363-6459

Mailing address

9203 Lee Hwy Ste 16
Ooltewah, TN 37363-6459
Phone (423) 414-3632

National Provider Directory

National Provider Directory

Locations

9203 Lee Hwy
Ste 16
Ooltewah, TN 37363
Phone (423) 238-5744

Practitioners & affiliated clinicians

Practitioners 1

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": "1780272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780272000000",
    "number": "1538091905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9203 LEE HWY STE 16",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636459",
            "telephone_number": "423-414-3632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9203 LEE HWY STE 16",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636459",
            "telephone_number": "423-414-3632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUNA DENTAL SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-01",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "RUCHI",
        "authorized_official_middle_name": "MUKESH",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "423-310-0075",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ooltewah, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; 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.