Organization Active NPI

Loganville Dental Associates

  • General Practice Dentistry
  • Loganville, GA
National Provider Identifier
1154682219
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LOGANVILLE DENTAL ASSOCIATES
Practice address
150 Highway 78
Loganville, GA 30052-2277
Phone
(770) 466-0580
NPI assigned
Jun 6, 2012
Last updated
Jun 6, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Authorized official

Name
Jane Hammond
Title
Office Manager
Phone
(770) 466-0580

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

150 Highway 78
Loganville, GA 30052-2277

Mailing address

150 Highway 78
Loganville, GA 30052-2277
Phone (770) 466-0580

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338940800000",
    "number": "1154682219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 HIGHWAY 78",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300522277",
            "telephone_number": "770-466-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 HIGHWAY 78",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300522277",
            "telephone_number": "770-466-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGANVILLE DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-06",
        "last_updated": "2012-06-06",
        "status": "A",
        "authorized_official_last_name": "HAMMOND",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-466-0580"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loganville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; 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.