Organization Active NPI

Legacy Dental Group, PLLC

  • Dental Clinic/Center
  • Chattanooga, TN
National Provider Identifier
1649174038
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
LEGACY DENTAL GROUP, PLLC
Practice address
4109 Mountain View Ave Ste 300
Chattanooga, TN 37415-2096
Phone
(423) 875-5661
NPI assigned
Oct 7, 2026
Last updated
Oct 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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

Authorized official

Name
Mrs. Marcy Kay
Title
Insurance Administrator
Phone
(423) 762-9992

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

4109 Mountain View Ave Ste 300
Chattanooga, TN 37415-2096

Mailing address

135 Twin Oaks CT
Dayton, TN 37321-5979
Phone (423) 762-9992

NPI Registry JSON

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

{
    "created_epoch": "1791331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791331200000",
    "number": "1649174038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 TWIN OAKS CT",
            "city": "DAYTON",
            "state": "TN",
            "postal_code": "373215979",
            "telephone_number": "423-762-9992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4109 MOUNTAIN VIEW AVE STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374152096",
            "telephone_number": "423-875-5661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY DENTAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-07",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A",
        "authorized_official_last_name": "KAY",
        "authorized_official_first_name": "MARCY",
        "authorized_official_title_or_position": "INSURANCE ADMINISTRATOR",
        "authorized_official_telephone_number": "423-762-9992",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.