Pediatric Dentistry Asleep of Georgia LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

PEDIATRIC DENTISTRY ASLEEP OF GEORGIA LLC

Practice address

888 Pine St
Macon, GA 31201-2109

Phone

(412) 672-4077

Fax

(412) 672-4570

NPI assigned

Nov 29, 2024

Organization subpart

Yes

Parent organization

PEDIATRIC DENTISTRY ASLEEP GROUP LLCAs reported in NPPES

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

Authorized official

Name

Dr. Johnny Joseph, DMD

Title

President

Phone

(857) 200-3312

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1732838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732838400000",
    "number": "1104642685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N LEWIS RUN RD STE 215A",
            "city": "WEST MIFFLIN",
            "state": "PA",
            "postal_code": "151223009",
            "telephone_number": "412-672-4077",
            "fax_number": "412-672-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 PINE ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012109",
            "telephone_number": "412-672-4077",
            "fax_number": "412-672-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY ASLEEP OF GEORGIA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEDIATRIC DENTISTRY ASLEEP GROUP LLC",
        "enumeration_date": "2024-11-29",
        "last_updated": "2024-11-29",
        "certification_date": "2024-11-29",
        "status": "A",
        "authorized_official_last_name": "JOSEPH",
        "authorized_official_first_name": "JOHNNY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "857-200-3312",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Peacock, CSFA
• Glenda J Pearce
• Boris Pechenik, MD
• Pedia Angels Family Healthcare
• Pediatric Care of Macon, LLC
• Pediatric Dentistry of Central Georgia - Macon LLC
• Pediatric Mobility
• Pediatric Mobility
• Pediatric Pulmonology of Central Ga
• Pediatric Services of America, LLC

• Pediatric Dentistry in Macon, GA
• Providers in Macon, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2024; 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.