Norcross Dental Center

Primary specialty

DentistTaxonomy code 122300000X

License

DN013031 Issued in GA

Legal business name

NORCROSS DENTAL CENTER

Practice address

5430 Jimmy Carter Blvd Ste 125
Norcross, GA 30093-1526

Phone

(770) 441-7900

NPI assigned

Apr 29, 2008

Organization subpart

No

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

Authorized official

Name

Thien Minh Le, DMD

Title

Owner

Phone

(770) 411-7900

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

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

• Dominique Duong, D.D.S.

  • Dentist
  • Norcross, GA
  • NPI 1093170458
  NPD (past)
• Long K Phung, DMD

  • Dentist
  • Lawrenceville, GA
  • NPI 1982088407
  NPD (past)

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1023283181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5430 JIMMY CARTER BLVD STE 125",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300931526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5430 JIMMY CARTER BLVD STE 125",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300931526",
            "telephone_number": "770-441-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORCROSS DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "THIEN",
        "authorized_official_middle_name": "MINH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-411-7900",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN013031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "232256189B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "232256189C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nine Sky LLC
• Joelle Noel
• Jessica Joy Noggle Taylor, PHD, APRN, NP-C
• Norcross Chiropractic & Physical Rehab, LLC
• Norcross Dental Associates
• Norcross Dialysis Center, LLC
• Norcross Eye Center
• Norcross MC Inc
• Norcross Pediatric and Family Medicine Corporation
• Norcross Pediatric Clinic Inc

• Dentist in Norcross, GA
• Providers in Norcross, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.