Provider Demographics
NPI:1821660549
Name:JAVADI, EMILY (DDS)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:JAVADI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3824 RINGGOLD RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37412-1640
Mailing Address - Country:US
Mailing Address - Phone:423-629-6015
Mailing Address - Fax:423-622-9974
Practice Address - Street 1:3824 RINGGOLD RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37412-1640
Practice Address - Country:US
Practice Address - Phone:423-629-6015
Practice Address - Fax:423-622-9974
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-13
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11661122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty