NPIMap

Organization Active NPI

Dentistry for Children Cdcoa LLC

  • Pediatric Dentistry
  • Atlanta, GA
National Provider Identifier
1144509852
Registry record updated Aug 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
DENTISTRY FOR CHILDREN CDCOA LLC
Practice address
4536 Chamblee Dunwoody Rd
Suite 211
Atlanta, GA 30338-6200
Phone
(770) 331-4104
NPI assigned
Aug 11, 2011
Last updated
Aug 11, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2011

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

Authorized official

Name
Teresa Blair
Title
Supervisor of Medicaid
Phone
(770) 331-4014

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X NU Primary

Addresses

Primary practice location

4536 Chamblee Dunwoody Rd
Suite 211
Atlanta, GA 30338-6200

Mailing address

1350 Spring St NW
Ste 600
Atlanta, GA 30309-2864

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1313020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313020800000",
    "number": "1144509852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 SPRING ST NW",
            "address_2": "STE 600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303092864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4536 CHAMBLEE DUNWOODY RD",
            "address_2": "SUITE 211",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303386200",
            "telephone_number": "770-331-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTRY FOR CHILDREN CDCOA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-11",
        "last_updated": "2011-08-11",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "SUPERVISOR OF MEDICAID",
        "authorized_official_telephone_number": "770-331-4014"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "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 11, 2011; 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.