Georgia Dental Alliance of Columbus

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

GEORGIA DENTAL ALLIANCE OF COLUMBUS

Practice address

6410 W Hamilton Park Dr
Columbus, GA 31909-3004

Phone

(706) 653-8700

NPI assigned

Nov 18, 2019

Last updated

Nov 18, 2019By 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

Christopher Sims

Title

Credentialing Specialist

Phone

(470) 552-1823

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574035200000",
    "number": "1053956771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 W HAMILTON PARK DR",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319093004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 W HAMILTON PARK DR",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319093004",
            "telephone_number": "706-653-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA DENTAL ALLIANCE OF COLUMBUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-18",
        "last_updated": "2019-11-18",
        "status": "A",
        "authorized_official_last_name": "SIMS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "470-552-1823"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; 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.