Ted W. Gaw, D.D.S. – General Practice Dentistry

Key facts

NPI: 1598802472
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Dentistry 1223G0001X
License: DS0000003304 (TN)
Practice address: 187 N Grundy Quarles Hwy
Gainesboro, TN 38562-9691
Phone: (931) 268-2869
Fax: (931) 268-9837
NPI assigned: Jan 31, 2007
Sex: Male
Sole proprietor: Yes

Organizations & group practices 1

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.

Gaw Family Dentistry General Practice Dentistry · Gainesboro, TN · NPI 1598205197

NPD (past) GENERAL PRACTICE

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
DS0000003304	TN	MD	General Practice Dentistry

Practice roles

Organization	Specialty	Status	New patients
Gaw Family Dentistry	General Practice	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Dentistry	1223G0001X	DS0000003304	TN	Yes

Addresses

Primary practice location

187 N Grundy Quarles Hwy
Gainesboro, TN 38562-9691

Mailing address

240 Cherry LN
Gainesboro, TN 38562-5538
Phone (931) 268-2597

Other identifiers

Identifier	Type	State	Issuer
0026412	Other	TN	BLUE CROSS BLUE SHIELD

Other providers in Gainesboro, TN

All providers in Gainesboro, TN · General Practice Dentistry in Tennessee

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.