Bradley Logan Winn, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7761 Issued in TN

Practice address

148 Stuart Xing NE
Cleveland, TN 37312-4065

Phone

(423) 472-6482

Fax

(423) 472-6699

NPI assigned

Feb 11, 2008

Sex

Male

Sole proprietor

No

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

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Smile Revolution PLLC

  • Dentist
  • Chattanooga, TN
  • NPI 1194502088
  NPD
• Winn Smiles Shallowford, PLLC

  • Dentist
  • Chattanooga, TN
  • NPI 1821768789
  NPD (past)

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556841600000",
    "number": "1578741773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 STUART CROSSING NE",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373120000",
            "telephone_number": "423-472-6482",
            "fax_number": "423-472-6699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 STUART XING NE",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373124065",
            "telephone_number": "423-472-6482",
            "fax_number": "423-472-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINN",
        "first_name": "BRADLEY",
        "middle_name": "LOGAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-11",
        "last_updated": "2019-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "7761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Patrick Wilson, DDS
• Tiffany Michelle Ladonna Wilson
• Lacy M Windham, MD
• Tammy Wingo-Salmond
• Winn Smiles Cleveland
• Alan Winter, D.PH.
• Teresa Melanie Winter, R.PH.
• Paige Wisebaker
• Marissa Lyn Withrow
• Debra Wittmaier, RN, PA

• General Practice Dentistry in Cleveland, TN
• Providers in Cleveland, 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 May 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.