PCDC Atlanta LLC

Primary specialty

DentistTaxonomy code 122300000X

License

DN011882 Issued in GA

Legal business name

PCDC ATLANTA LLC

Doing business as

Peachtree-Collier Dental Care

Practice address

3098 Piedmont Rd NE
Suite 100
Atlanta, GA 30305-2637

Phone

(404) 351-9307

Fax

(404) 355-2555

NPI assigned

Sep 23, 2014

Organization subpart

No

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

Authorized official

Name

Dr. G. Joseph Peluso III, DMD

Title

Sole Managing Member

Phone

(404) 405-7756

Specialties & licenses 1

Addresses

Other names 1

• Peachtree-Collier Dental Care Doing business as

Locations

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479772800000",
    "number": "1154723062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3098 PIEDMONT RD NE",
            "address_2": "SUITE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052637",
            "telephone_number": "404-351-9307",
            "fax_number": "404-355-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3098 PIEDMONT RD NE",
            "address_2": "SUITE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052637",
            "telephone_number": "404-351-9307",
            "fax_number": "404-355-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PCDC ATLANTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-23",
        "last_updated": "2016-11-22",
        "status": "A",
        "authorized_official_last_name": "PELUSO",
        "authorized_official_first_name": "G.",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "SOLE MANAGING MEMBER",
        "authorized_official_telephone_number": "404-405-7756",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN011882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peachtree-Collier Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.