NPIMap

Organization Active NPI

Snow White Smiles, PC

  • General Practice Dentistry
  • Berkeley Lake, GA
National Provider Identifier
1003365966
Registry record updated Oct 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN012820 Issued in GA
Legal business name
SNOW WHITE SMILES, PC
Practice address
4720 Peachtree Industrial Blvd
302
Berkeley Lake, GA 30071-5735
Phone
(404) 583-3090
NPI assigned
Oct 3, 2016
Last updated
Oct 3, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2016

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

Authorized official

Name
Marjan MalekNPI 1942288063
Title
Owner
Phone
(404) 583-3090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN012820 GA Primary

Addresses

Primary practice location

4720 Peachtree Industrial Blvd
302
Berkeley Lake, GA 30071-5735

Mailing address

454 Loridans Dr NE
Atlanta, GA 30342-3406

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1475452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475452800000",
    "number": "1003365966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 LORIDANS DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303423406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 PEACHTREE INDUSTRIAL BLVD",
            "address_2": "302",
            "city": "BERKELEY LAKE",
            "state": "GA",
            "postal_code": "300715735",
            "telephone_number": "404-583-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNOW WHITE SMILES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-03",
        "last_updated": "2016-10-03",
        "status": "A",
        "authorized_official_last_name": "MALEK",
        "authorized_official_first_name": "MARJAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-583-3090"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley Lake, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; 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.