NPIMap

Organization Active NPI

Royal Dental Group

  • General Practice Dentistry
  • Gainesville, GA
National Provider Identifier
1063651511
Registry record updated Feb 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN012868 Issued in GA
Legal business name
ROYAL DENTAL GROUP
Practice address
821 Dawsonville Hwy Ste 150
Gainesville, GA 30501-2634
Phone
(770) 503-7130
Fax
(770) 503-7131
NPI assigned
Feb 6, 2009
Last updated
Feb 6, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2009

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

Authorized official

Name
Katashia Holmes, D.D.SNPI 1821063058
Title
Dentist
Phone
(770) 503-7130

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DN012868 GA Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DN013188 GA

Addresses

Primary practice location

821 Dawsonville Hwy Ste 150
Gainesville, GA 30501-2634

Mailing address

821 Dawsonville Hwy Ste 150
Gainesville, GA 30501-2634
Phone (770) 503-7130

Other identifiers 3

IdentifierTypeStateIssuer
199726296AMedicaidGA
199726296EMedicaidGA
199726296FMedicaidGA

National Provider Directory

National Provider Directory

Locations

821 Dawsonville Hwy
Ste 150
Gainesville, GA 30501
Phone (770) 503-7130

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1233878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233878400000",
    "number": "1063651511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 DAWSONVILLE HWY STE 150",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012634",
            "telephone_number": "770-503-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 DAWSONVILLE HWY STE 150",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012634",
            "telephone_number": "770-503-7130",
            "fax_number": "770-503-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROYAL DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-06",
        "last_updated": "2009-02-06",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "KATASHIA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "770-503-7130",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012868",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013188",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199726296A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199726296E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199726296F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.