NPIMap

Organization Active NPI

Princeton Dental Group

  • General Practice Dentistry
  • Buford, GA
National Provider Identifier
1013234954
Registry record updated May 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PRINCETON DENTAL GROUP
Practice address
4700 Nelson Brogdon Blvd
Suite 210
Buford, GA 30518-5400
Phone
(678) 730-2005
Fax
(678) 730-2008
NPI assigned
May 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2010

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

Authorized official

Name
Mr. Dale L Bailey
Title
Vice President
Phone
(678) 730-2005

Specialties & licenses 1

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

Addresses

Primary practice location

4700 Nelson Brogdon Blvd
Suite 210
Buford, GA 30518-5400

Mailing address

4700 Nelson Brogdon Blvd
Suite 210
Buford, GA 30518-5400
Phone (678) 730-2005

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1272844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272844800000",
    "number": "1013234954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 NELSON BROGDON BLVD",
            "address_2": "SUITE 210",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305185400",
            "telephone_number": "678-730-2005",
            "fax_number": "678-730-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 NELSON BROGDON BLVD",
            "address_2": "SUITE 210",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305185400",
            "telephone_number": "678-730-2005",
            "fax_number": "678-730-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCETON DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-03",
        "last_updated": "2010-05-03",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "678-730-2005",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buford, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2010; 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.