Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southeastern Dental Associates of Soddy Daisy

Organization Dentist · NPI 1790821148

Southeastern Dental Associates of Soddy Daisy is a Dentist in Soddy Daisy, Tennessee. Licensed in Tennessee. Registered with an NPI since 2007.

Licensed in
TN
In the registry since
2007
Specialties on file
2

Practice location Address checks out

11246 Dayton Pike
Soddy Daisy, TN 37379
Phone: (423) 332-0500
Fax: (423) 332-0920
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X
Dentist Taxonomy 122300000X · Licence 8527 (TN)

Record details

NPI number1790821148
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Nicholas Bowman — President · (423) 332-0500
NPI enumeratedJanuary 30, 2007
Last updated in NPPESJuly 2, 2026
Certification dateJuly 2, 2026
Mailing address11246 Dayton Pike, Soddy Daisy, TN 37379