NPIMap

Organization Active NPI

Loganville Family Dentistry

  • General Practice Dentistry
  • Loganville, GA
National Provider Identifier
1033344650
Registry record updated May 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LOGANVILLE FAMILY DENTISTRY
Practice address
3973 Atlanta Hwy
Suite 100
Loganville, GA 30052-3752
Phone
(770) 466-3114
Fax
(770) 466-3777
NPI assigned
May 27, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2009

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

Authorized official

Name
Dr. Ponnie D PoisalNPI 1679577936
Title
DMD / Owner
Phone
(770) 466-3114

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 Primary

Addresses

Primary practice location

3973 Atlanta Hwy
Suite 100
Loganville, GA 30052-3752

Mailing address

3973 Atlanta Hwy
Suite 100
Loganville, GA 30052-3752
Phone (770) 466-3114

National Provider Directory

National Provider Directory

Locations

3973 Atlanta Hwy
Ste 100
Loganville, GA 30052
Phone (770) 466-3114

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": "1243382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243382400000",
    "number": "1033344650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3973 ATLANTA HWY",
            "address_2": "SUITE 100",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300523752",
            "telephone_number": "770-466-3114",
            "fax_number": "770-466-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3973 ATLANTA HWY",
            "address_2": "SUITE 100",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300523752",
            "telephone_number": "770-466-3114",
            "fax_number": "770-466-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGANVILLE FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-27",
        "last_updated": "2009-05-27",
        "status": "A",
        "authorized_official_last_name": "POISAL",
        "authorized_official_first_name": "PONNIE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DMD / OWNER",
        "authorized_official_telephone_number": "770-466-3114",
        "authorized_official_name_prefix": "Dr."
    },
    "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 Loganville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; 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.