NPIMap

Organization Active NPI

Heartland Dental Care of Georgia

Doing business as Family Dental of Canton

  • General Practice Dentistry
  • Canton, GA
National Provider Identifier
1003233107
Registry record updated Mar 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
HEARTLAND DENTAL CARE OF GEORGIA
Doing business as
Family Dental of Canton
Practice address
3237 Sixes Rd
Canton, GA 30114
Phone
(770) 450-1689
NPI assigned
Mar 26, 2014
Last updated
Mar 26, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
HEARTLAND DENTAL CARE OF GEORGIAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 26, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jean Cornell
Title
Credentialing Coordinator
Phone
(217) 540-8329

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3237 Sixes Rd
Canton, GA 30114

Mailing address

3237 Sixes Rd
Canton, GA 30114
Phone (770) 450-1689

Other names 1

  • Family Dental of Canton Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Dental Care of Georgia72 organizations share this tax ID, including this one
Part of
Heartland Dental Care of Georgia

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395792000000",
    "number": "1003233107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3237 SIXES RD",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "30114",
            "telephone_number": "770-450-1689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3237 SIXES RD",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "30114",
            "telephone_number": "770-450-1689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND DENTAL CARE OF GEORGIA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEARTLAND DENTAL CARE OF GEORGIA",
        "enumeration_date": "2014-03-26",
        "last_updated": "2014-03-26",
        "status": "A",
        "authorized_official_last_name": "CORNELL",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8329"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Dental of Canton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.