NPIMap

Organization Active NPI

North Decatur Dentistry, PC

Doing business as North Decatur Dentistry

  • General Practice Dentistry
  • Decatur, GA
National Provider Identifier
1154868917
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NORTH DECATUR DENTISTRY, PC
Doing business as
North Decatur Dentistry
Practice address
2570 Blackmon Drive
Suite 320
Decatur, GA 30033
Phone
(678) 203-3462
Fax
(678) 389-6421
NPI assigned
Jan 31, 2017
Last updated
Jan 31, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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

Authorized official

Name
Dr. Katie L McCann, DDS
Title
Owner
Phone
(678) 203-3462

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2570 Blackmon Drive
Suite 320
Decatur, GA 30033

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8890

Other names 1

  • North Decatur Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

2570 Blackmon Dr
Ste 310
Decatur, GA 30033
Phone (678) 203-3462

2570 Blackmon Dr
Ste 320
Decatur, GA 30033
Phone (678) 203-3462

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1485820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485820800000",
    "number": "1154868917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 BLACKMON DRIVE",
            "address_2": "SUITE 320",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "30033",
            "telephone_number": "678-203-3462",
            "fax_number": "678-389-6421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH DECATUR DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-31",
        "last_updated": "2017-01-31",
        "status": "A",
        "authorized_official_last_name": "MCCANN",
        "authorized_official_first_name": "KATIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-203-3462",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Decatur Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; 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.