Bella Cosmetic and Family Dentistry

Key facts

NPI

1154743136

Entity type

Organization (NPI type 2)

Primary specialty

Dentist 122300000X

License

DNO13198 (GA)

Legal business name

BELLA COSMETIC AND FAMILY DENTISTRY

Practice address

4574 Lawrenceville Hwy NW
Suite 120
Lilburn, GA 30047-3647

Phone

(770) 921-9000

NPI assigned

Jan 10, 2014

Organization subpart

No

Authorized official

Name

Dr. Roderick S Cooper, D.D.S NPI 1831109149

Title

Owner

Phone

(770) 921-9000

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roderick Sampson Cooper, D.D.S. General Practice Dentistry · Hazelwood, MO · NPI 1831109149
  NPD (past) Authorized official
• Mehtab Manji General Practice Dentistry · Tucker, GA · NPI 1497404917
  NPD (past)

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 28, 2014.

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395964800000",
    "number": "1154743136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4574 LAWRENCEVILLE HWY NW",
            "address_2": "SUITE 120",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473647",
            "telephone_number": "770-921-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4574 LAWRENCEVILLE HWY NW",
            "address_2": "SUITE 120",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473647",
            "telephone_number": "770-921-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLA COSMETIC AND FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-10",
        "last_updated": "2014-03-28",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "RODERICK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-921-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "DNO13198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lilburn, GA

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• Dianne Jean-Marie Bennett-Johnson, M.D.
• Danisha Bennett, NMT, LMT
• Katharine J Benton, PT, DPT
• Nardos A Benton, DMD

All providers in Lilburn, GA · Dentist in Georgia