NPIMap

Organization Active NPI

Renew Dental, Inc

  • General Practice Dentistry
  • Cornelia, GA
National Provider Identifier
1003522632
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
RENEW DENTAL, INC
Practice address
157 Hodges St
Cornelia, GA 30531-3295
Phone
(706) 894-1919
Fax
(706) 894-1925
NPI assigned
Jan 26, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Authorized official

Name
Dr. Donald Cantrell Jr., DMD
Title
President
Phone
(706) 768-7269

Specialties & licenses 1

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

Addresses

Primary practice location

157 Hodges St
Cornelia, GA 30531-3295

Mailing address

PO Box 459
Cornelia, GA 30531-1006
Phone (706) 894-1919

Other practice location 1

5332 Highway 115 Ste A
Clarkesville, GA 30523-6750
Phone (706) 754-3215

National Provider Directory

National Provider Directory

Locations

5332 Highway 115
Ste A
Clarkesville, GA 30523
Phone (706) 754-3215

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1674691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674691200000",
    "number": "1003522632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 459",
            "city": "CORNELIA",
            "state": "GA",
            "postal_code": "305311006",
            "telephone_number": "706-894-1919",
            "fax_number": "706-894-1925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 HODGES ST",
            "city": "CORNELIA",
            "state": "GA",
            "postal_code": "305313295",
            "telephone_number": "706-894-1919",
            "fax_number": "706-894-1925"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5332 Highway 115 Ste A",
            "address_purpose": "LOCATION",
            "city": "Clarkesville",
            "state": "GA",
            "postal_code": "305236750",
            "country_code": "US",
            "telephone_number": "706-754-3215",
            "fax_number": "706-894-1925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RENEW DENTAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-26",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A",
        "authorized_official_last_name": "CANTRELL",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-768-7269",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornelia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.