NPIMap

Organization Active NPI

Heartland Dental Care of Georgia, P.C.

Doing business as Braselton Dental Care

  • General Practice Dentistry
  • Braselton, GA
National Provider Identifier
1144659996
Registry record updated Nov 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
HEARTLAND DENTAL CARE OF GEORGIA, P.C.
Doing business as
Braselton Dental Care
Practice address
2625 Old Winder Hwy Ste G
Braselton, GA 30517-7021
Phone
(855) 343-4056
NPI assigned
Nov 2, 2013
Last updated
Nov 2, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
HEARTLAND DENTAL CARE OF GEORGIA, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 2, 2013

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

Authorized official

Name
Kim Wilson
Title
Cred. Supervisor
Phone
(217) 540-5170

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

2625 Old Winder Hwy Ste G
Braselton, GA 30517-7021

Mailing address

2625 Old Winder Hwy Ste G
Braselton, GA 30517-7021
Phone (855) 343-4056

Other names 1

  • Braselton Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Georgia Dental Professionals PC72 organizations share this tax ID, including this one
Part of
Georgia Dental Professionals PC

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

Practitioners & affiliated clinicians

Practitioners 2

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": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383350400000",
    "number": "1144659996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 OLD WINDER HWY STE G",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "305177021",
            "telephone_number": "855-343-4056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 OLD WINDER HWY STE G",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "305177021",
            "telephone_number": "855-343-4056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND DENTAL CARE OF GEORGIA, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEARTLAND DENTAL CARE OF GEORGIA, P.C.",
        "enumeration_date": "2013-11-02",
        "last_updated": "2013-11-02",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CRED. SUPERVISOR",
        "authorized_official_telephone_number": "217-540-5170"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Braselton Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Braselton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.