NPIMap

Organization Active NPI

Buckhead Dental Associates, P.C.

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1073516662
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
GA8628 GA10187GA9232 Issued in GA
Legal business name
BUCKHEAD DENTAL ASSOCIATES, P.C.
Practice address
3340 Peachtree Rd NE
Ste 1685
Atlanta, GA 30326-1012
Phone
(404) 266-1300
Fax
(404) 365-8526
NPI assigned
May 27, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kristin Benninger
Title
Hipaa Compliance Officer
Phone
(404) 266-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X GA8628 GA10187GA9232 GA Primary

Addresses

Primary practice location

3340 Peachtree Rd NE
Ste 1685
Atlanta, GA 30326-1012

Mailing address

3340 Peachtree Rd NE
Ste 1685
Atlanta, GA 30326-1012
Phone (404) 266-1300

National Provider Directory

National Provider Directory

Locations

3340 Peachtree Rd NE
Ste 1685
Atlanta, GA 30326
Phone (404) 266-1300

Practitioners & affiliated clinicians

Practitioners 3

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": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073516662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 PEACHTREE RD NE",
            "address_2": "STE 1685",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261012",
            "telephone_number": "404-266-1300",
            "fax_number": "404-365-8526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 PEACHTREE RD NE",
            "address_2": "STE 1685",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261012",
            "telephone_number": "404-266-1300",
            "fax_number": "404-365-8526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKHEAD DENTAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BENNINGER",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "HIPAA COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "404-266-1300"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "GA8628 GA10187GA9232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.