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Active NPI 1114509080 Individual Practitioner Male Practitioner

Dr. Tanner Gray , DMD

Dentist - General Practice • Holloman Afb, NM

Professional Overview & Biography Verified Profile Summary

Dr. Tanner Gray, DMD is a registered healthcare professional specializing in Dentist - General Practice in Holloman Afb, NM. Practice services are available at 49 MDG, 280 DAVID L. GOLDFEIN STREET, BLDG 20 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

49 Mdg, 280 David L. Goldfein Street, Bldg 20

Holloman Afb, NM 88330

Telephone 5755728099

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Holloman Afb, NM

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 9.6 Yrs
Regional Practice Density
5 Specialists

Practicing in Holloman Afb, NM (761 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-09-18
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License UT 12322243-9926

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1609616945

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
📍
Updated Practice Location September 18, 2025

Registered at 49 MDG, 280 DAVID L. GOLDFEIN STREET, BLDG 20, HOLLOMAN AFB, NM 88330 (Tel: 5755728099)

📍
Updated Business Mailing Address September 18, 2025

Registered at 49 MDG, 280 DAVID L. GOLDFEIN STREET, BLDG 20, HOLLOMAN AFB, NM 88330

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 18, 2025

Dentist (License #12322243-9926 in UT)

📍
Updated Practice Location August 24, 2023

Registered at BUILDING 20, SANTA FE DR, HOLLOMAN AFB, NM 88330 (Tel: 5755728099)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 23, 2021

Dentist (License #12322243-8903 in UT)

NPI Profile Active April 21, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location April 21, 2021

Registered at 1650 E 3250 N, NORTH LOGAN, UT 843411615 (Tel: 4357709709)

📍
Updated Business Mailing Address April 21, 2021

Registered at 1650 E 3250 N, NORTH LOGAN, UT 843411615 (Tel: 4357709709)

👤
Provider Name / Credentials Updated April 21, 2021

Recorded as TANNER GRAY, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 21, 2021

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 21, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114509080
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 21, 2021
Last Update: September 18, 2025
Sole Proprietor: No

Mailing Address

49 Mdg, 280 David L. Goldfein Street, Bldg 20

Holloman Afb, NM 88330

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.