East Cobb Nia LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN013543 Issued in GA

Legal business name

EAST COBB NIA LLC

Practice address

1111 Johnson Ferry Rd
Marietta, GA 30068-2181

Phone

(770) 479-9999

NPI assigned

Oct 13, 2016

Organization subpart

No

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

Authorized official

Name

Sara Sebastian

Title

Billing/Insurance Manager

Phone

(770) 479-9999

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1003366147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 JOHNSON FERRY RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30068",
            "telephone_number": "770-479-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 JOHNSON FERRY RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300682181",
            "telephone_number": "770-479-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST COBB NIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-13",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "SEBASTIAN",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "BILLING/INSURANCE MANAGER",
        "authorized_official_telephone_number": "770-479-9999"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN013543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Cobb Hand Therapy LLC
• East Cobb Health
• East Cobb Massage Therapy, Inc
• East Cobb Medical Clinic, LLC
• East Cobb MRI Center
• East Cobb Pediatrics and Adolescent Medicine, PC
• East Cobb Physical Therapy, LLC
• East Cobb Physical Therapy, LLC
• East Cobb Podiatry Surgery Center, LLC
• East Cobb Relationship Center

• Pediatric Dentistry in Marietta, GA
• Providers in Marietta, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.