Stonewalk Family Dentistry

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

STONEWALK FAMILY DENTISTRY

Practice address

5304 Windward Pkwy
Suite 107
Milton, GA 30004-3843

Phone

(770) 777-1911

NPI assigned

Jan 6, 2013

Last updated

Jan 6, 2013By 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

Farhad Nia, DMD

Title

Owner/Dentist

Phone

(770) 777-1911

Specialties & licenses 1

Addresses

Locations

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.

• Jung M. Lee, D.M.D.

  • General Practice Dentistry
  • Milton, GA
  • NPI 1518273747
  NPD (past)

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

{
    "created_epoch": "1357430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357430400000",
    "number": "1083951479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5304 WINDWARD PKWY",
            "address_2": "SUITE 107",
            "city": "MILTON",
            "state": "GA",
            "postal_code": "300043843",
            "telephone_number": "770-777-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5304 WINDWARD PKWY",
            "address_2": "SUITE 107",
            "city": "MILTON",
            "state": "GA",
            "postal_code": "300043843",
            "telephone_number": "770-777-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONEWALK FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-06",
        "last_updated": "2013-01-06",
        "status": "A",
        "authorized_official_last_name": "NIA",
        "authorized_official_first_name": "FARHAD",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "770-777-1911",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Milton, GA
• Providers in Milton, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2013; 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.