Healthcare Provider Details

I. General information

NPI: 1386579688
Provider Name (Legal Business Name): JEROD JAMES FRITTS DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 DODDS AVE
CHATTANOOGA TN
37404-4754
US

IV. Provider business mailing address

110 SOMERVILLE AVE APT 214
CHATTANOOGA TN
37405-3368
US

V. Phone/Fax

Practice location:
  • Phone: 423-206-9641
  • Fax:
Mailing address:
  • Phone: 601-701-5532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number13195
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: