Iclear Orthodontics and Braces LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN014542 Issued in GA

Legal business name

ICLEAR ORTHODONTICS AND BRACES LLC

Doing business as

Orthodontic excellence

Practice address

420 McDonough Pkwy
McDonough, GA 30253-8946

Phone

(770) 914-2808

NPI assigned

Feb 12, 2016

Organization subpart

No

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

Authorized official

Name

Ruchir Patel, DDS

Title

Manager

Phone

(770) 914-2808

Specialties & licenses 1

Addresses

Other names 1

• Orthodontic excellence Doing business as

Locations

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455235200000",
    "number": "1104285535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 MCDONOUGH PKWY",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302538946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 MCDONOUGH PKWY",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302538946",
            "telephone_number": "770-914-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICLEAR ORTHODONTICS AND BRACES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-12",
        "last_updated": "2016-02-12",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "RUCHIR",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "770-914-2808",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": "DN014542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orthodontic excellence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in McDonough, GA
• Providers in McDonough, GA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2016; 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.