NPIMap

Organization Active NPI

Norcross Pediatric Dentistry

  • Pediatric Dentistry
  • Norcross, GA
National Provider Identifier
1124561022
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN013057 Issued in GA
Legal business name
NORCROSS PEDIATRIC DENTISTRY
Practice address
5635 Peachtree Pkwy
Suite 200
Norcross, GA 30092-2879
Phone
(770) 651-1000
NPI assigned
Nov 23, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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

Authorized official

Name
Dr. Vishant Nath, DMD
Title
Dentist
Phone
(770) 651-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X DN013057 GA Primary

Addresses

Primary practice location

5635 Peachtree Pkwy
Suite 200
Norcross, GA 30092-2879

Mailing address

5635 Peachtree Pkwy
Suite 200
Norcross, GA 30092-2879
Phone (770) 651-1000

National Provider Directory

National Provider Directory
Tax ID family
Norcross Pediatric Dentistry4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5635 Peachtree Pkwy
Ste 200
Peachtree Corners, GA 30092
Phone (678) 990-1001

NPI Registry JSON

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

{
    "created_epoch": "1479859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479859200000",
    "number": "1124561022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5635 PEACHTREE PKWY",
            "address_2": "SUITE 200",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300922879",
            "telephone_number": "770-651-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5635 PEACHTREE PKWY",
            "address_2": "SUITE 200",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300922879",
            "telephone_number": "770-651-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORCROSS PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-23",
        "last_updated": "2016-11-23",
        "status": "A",
        "authorized_official_last_name": "NATH",
        "authorized_official_first_name": "VISHANT",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "770-651-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN013057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.