Southeastern Dental Associates of Soddy Daisy

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SOUTHEASTERN DENTAL ASSOCIATES OF SODDY DAISY

Practice address

11246 Dayton Pike
Soddy Daisy, TN 37379

Phone

(423) 332-0500

Fax

(423) 332-0920

NPI assigned

Jan 30, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Nicholas Eugene Bowman, D.M.D.NPI 1265548952

Title

President

Phone

(423) 332-0500

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicholas Eugene Bowman, DMD

  • General Practice Dentistry
  • Soddy Daisy, TN
  • NPI 1265548952
  NPD (past) Authorized official

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782950400000",
    "number": "1790821148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11246 DAYTON PIKE",
            "city": "SODDY DAISY",
            "state": "TN",
            "postal_code": "37379",
            "telephone_number": "423-332-0500",
            "fax_number": "423-332-0920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11246 DAYTON PIKE",
            "city": "SODDY DAISY",
            "state": "TN",
            "postal_code": "37379",
            "telephone_number": "423-332-0500",
            "fax_number": "423-332-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN DENTAL ASSOCIATES OF SODDY DAISY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-332-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TN",
            "license": "8527",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Soddy Daisy Healthcare, LLC (Soddy-Daisy Health Care Center)
• Soddy Daisy Medical Care
• Soddy Daisy Pediatrics
• Soddy-Daisy TN Opco LLC (Soddy-Daisy Healthcare Center)
• Southeast Eye Specialists, PLLC
• Bethany Marie Taylor, OTR/L
• Tennessee CVS Pharmacy LLC (CVS Pharmacy #05694)
• The Oxygen Store, Inc. (Oxygen and More)
• Detraves Neville Thicklin, ATC
• Thomas C. Flanagan, D.D.S.

• General Practice Dentistry in Soddy Daisy, TN
• Providers in Soddy Daisy, 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 Jul 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.