Dentistry for Children of Suwanee, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

DENTISTRY FOR CHILDREN OF SUWANEE, LLC

Practice address

3855 Johns Creek Pkwy Ste D
Suwanee, GA 30024-1293

Phone

(678) 473-1199

Fax

(678) 473-1701

NPI assigned

Nov 10, 2010

Last updated

Nov 10, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Charles Coulter

Title

Pediatric Dentist

Phone

(770) 473-1350

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1289347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289347200000",
    "number": "1033410857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 COUNTRY CLUB DR",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817350",
            "telephone_number": "770-473-1350",
            "fax_number": "770-692-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 JOHNS CREEK PKWY STE D",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241293",
            "telephone_number": "678-473-1199",
            "fax_number": "678-473-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTRY FOR CHILDREN OF SUWANEE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-10",
        "last_updated": "2010-11-10",
        "status": "A",
        "authorized_official_last_name": "COULTER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "770-473-1350",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denoir LLC
• Bradley Scot Denovchek, RPH
• Dental Sleep Therapy LLC
• Dentistry 4 You LLC
• Dentistry at Suwanee, P.C.
• Dentistry of Suwanee
• Aileen Deogracias, OTR/L
• Katelyn Derogatis, LPC, NCC
• Ami Desai, DMD
• Mausami Desai

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.