Ga Dentistry Services PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13892 Issued in GA

Legal business name

GA DENTISTRY SERVICES PC

Doing business as

Aspen Dental

Practice address

1430 Highway 20 W
McDonough, GA 30253-7305

Phone

(678) 537-6000

NPI assigned

Mar 29, 2014

Organization subpart

No

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

Authorized official

Name

Candace Lauderdale, DMD

Title

DMD/Incorporator

Phone

(315) 454-6000

Specialties & licenses 1

Addresses

Other names 1

• Aspen Dental Doing business as

Practitioners 2

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

• Candis Marie Callaway, DMD

  • Dentist
  • McDonough, GA
  • NPI 1568986198
  NPD (past)
• Destiny Redding, DMD

  • Dentist
  • McDonough, GA
  • NPI 1104591023
  NPD (past)

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

{
    "created_epoch": "1396051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396051200000",
    "number": "1053739979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189",
            "telephone_number": "315-454-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 HIGHWAY 20 W",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302537305",
            "telephone_number": "678-537-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GA DENTISTRY SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-29",
        "last_updated": "2014-03-29",
        "status": "A",
        "authorized_official_last_name": "LAUDERDALE",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_title_or_position": "DMD/INCORPORATOR",
        "authorized_official_telephone_number": "315-454-6000",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "13892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aspen Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Functions Healthcare Services LLC
• Kimberly Funte, M.ED.
• Jamila M Furtch, LPC
• Joi Fuss, N.P.
• G.R. Foster III D.M.D. P.C.
• Ga Doctors of Optometry LLC
• Thomas Gailes, PT
• Rachel Daleth Gainsbrugh, PHARM.D.
• Jeffrey Allen Galloway, MPT, OTR/L,MTC,CHT,C
• Valerie Lynne Galloway, PTA

• General Practice Dentistry in McDonough, GA
• Providers in McDonough, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2014; 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.