Paul Gardner, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

9300 Issued in TN

Practice address

1515 Gunbarrel Rd
Ste 126
Chattanooga, TN 37421-4091

Phone

(423) 308-5597

Fax

(423) 308-5598

NPI assigned

Jun 13, 2011

Sex

Male

Sole proprietor

Yes

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.

• Emerald Dental PLLC

  • Dentist
  • Chattanooga, TN
  • NPI 1548703945
  NPD Authorized official

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486339200000",
    "number": "1619262102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 GUNBARREL RD",
            "address_2": "STE 126",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214091",
            "telephone_number": "423-308-5597",
            "fax_number": "423-308-5598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 GUNBARREL RD",
            "address_2": "STE 126",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214091",
            "telephone_number": "423-308-5597",
            "fax_number": "423-308-5598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-13",
        "last_updated": "2017-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "9300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Garcia, PA-C
• David Gardenhire
• Tom M Gardenhire Jr., D.D.S.
• Jennifer Ann Gardner Cummins, MA
• John Kevin Gardner, C.P.
• Vincent Wayne Gardner, M.D.
• Warren Ewing Gardner II, MD
• Katie Marie Gareri, M.ED., BCBA
• Misha Wiegand Garey, D.D.S.
• Alexander Garland III, APRN, PMHNP-BC

• 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 6, 2017; 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.