Individual provider Active NPI

William David Fox, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Chattanooga, TN
National Provider Identifier
1720037500
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS3362 Issued in TN
Practice address
4110C Brainerd Rd
Chattanooga, TN 37411
Phone
(423) 629-9771
Fax
(423) 629-4006
NPI assigned
May 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS3362 TN Primary

Addresses

Primary practice location

4110C Brainerd Rd
Chattanooga, TN 37411

Mailing address

6116 Shallowford Road
Suite 102
Chattanooga, TN 37421-7203
Phone (423) 629-9771

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190822002321 TN Practitioner - Oral Surgery 6103096110 Practice locations: Chattanooga, TN

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS3362TNMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Medical Properties, LLC Past Accepting new patients
Associates in Oral and Maxillofacial Surgery, P. C. PastSince Dec 14, 1998 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1720037500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6116 SHALLOWFORD ROAD",
            "address_2": "SUITE 102",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374217203",
            "telephone_number": "423-629-9771",
            "fax_number": "423-629-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110C BRAINERD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37411",
            "telephone_number": "423-629-9771",
            "fax_number": "423-629-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "WILLIAM",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "DS3362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.