BRYAN J. OTIS (NPI# 1659894343) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659894343 |
| Entity Type | Individual |
| Full Name | BRYAN J. OTIS |
| Credential | DDS |
| Practice Address |
4957 Swinyar Dr Ooltewah TN 37363-2204 |
| Practice Telephone | 4233963154 |
| Practice Fax Number | 4233963154 |
| Mailing Telephone | 4233963154 |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2017-07-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
10597 | TN | Dental Providers |
| Street Address |
4957 SWINYAR DR |
| City | OOLTEWAH |
| State | TN |
| Zip Code | 37363-2204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386688174 | Cheryl A. Haag | Podiatrist | 4957 Swinyar Dr, Ste 105, Ooltewah, TN 37363-2205 | 2006-06-15 |
| 1871639351 | David Harold Otis | Dentist | 4957 Swinyar Dr, Suite 107, Ooltewah, TN 37363-2204 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487203196 | University Health Center | Clinic/Center | 4687 University Drive, Ooltewah, TN 37363 | 2019-09-05 |
| 1508426560 | Alexandra Scott | Dentist | 8985 Old Lee Hwy, Suite 103, Ooltewah, TN 37363 | 2019-06-20 |
| 1093286304 | Wright Pediatric Dentistry | Dentist | 8202 Apison Pike, Ooltewah, TN 37363 | 2018-12-13 |
| 1770052888 | Bio-medical Applications of Tennessee, Inc. | Clinic/Center | 6085 Arbury Way, Ooltewah, TN 37363 | 2018-11-19 |
| 1679055008 | Rebecca Brown | Nurse Practitioner | 9801 Robinson Farm Rd, Ooltewah, TN 37363 | 2018-09-01 |
| 1750877833 | Amanda Kirkpatrick | Dietitian, Registered | 6103 Hunter Crest Drive, Ooltewah, TN 37363 | 2018-07-02 |
| 1447759493 | Abigale Daniels | Specialist/Technologist | 6154 Wardwell Drive, Ooltewah, TN 37363 | 2018-02-06 |
| 1538671748 | Ryan Volking | Physician Assistant | 7564 Passport Dr, Ooltewah, TN 37363 | 2017-10-27 |
| 1255882270 | Stella Tsui | Physical Therapy Assistant | 3818 Chanterwood Trl, Ooltewah, TN 37363 | 2016-10-14 |
| 1013392299 | Rhonda Wilson | Counselor | 5516 Barons Point, Ooltewah, TN 37363 | 2015-07-29 |
| Find all providers in zip 37363 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962014399 | Jordan Evans | Dentist | 4957 Swinyar Dr Ste 111, Ooltewah, TN 37363-2205 | 2020-08-18 |
| 1447807367 | Kara Hancock | Dentist | 5564 Little Debbie Pkwy Ste 120, Ooltewah, TN 37363-4356 | 2019-08-26 |
| 1508426560 | Alexandra Scott | Dentist | 8985 Old Lee Hwy, Suite 103, Ooltewah, TN 37363 | 2019-06-20 |
| 1417365578 | Art of Dentistry, Pllc | Dentist | 5913 Main St Ste 101, Ooltewah, TN 37363-7832 | 2014-08-01 |
| 1770870016 | Austin Shaun Roberts | Dentist | 6107 Ooltewah Georgetown Rd, Ooltewah, TN 37363-5656 | 2011-07-07 |
| 1154311884 | Todd Evans Ealy | Dentist | 9203 Lee Hwy, Suite 16, Ooltewah, TN 37363-6458 | 2005-10-25 |
| 1326406158 | Dr. Austin Roberts Family and Implant Dentistry, Pllc | Dentist | 6107 Ooltewah Georgetown Rd, Ooltewah, TN 37363-5656 | 2016-02-08 |
| 1770845190 | Callie L Doyle Dmd Pllc | Dentist | 5572 Little Debbie Pkwy, Ooltewah, TN 37363-4364 | 2012-06-12 |
| 1023320355 | Callie L M Doyle | Dentist | 5572 Little Debbie Pkwy, Suite 120, Ooltewah, TN 37363-4364 | 2010-07-01 |
| 1790804367 | Malcolm Drew Shabo | Dentist | 5958 Snow Hill Rd, Ste 144 Pmb 204, Ooltewah, TN 37363-7833 | 2007-03-28 |
| Find all providers in OOLTEWAH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.