NPIMap

Organization Active NPI

Coweta Dentistry Sda PC

Doing business as Coweta Dentistry Associates

  • General Practice Dentistry
  • Newnan, GA
National Provider Identifier
1164064481
Registry record updated Oct 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COWETA DENTISTRY SDA PC
Doing business as
Coweta Dentistry Associates
Practice address
203 Millard Farmer Ind Blvd
Newnan, GA 30263-1012
Phone
(770) 253-3595
NPI assigned
Oct 9, 2019
Last updated
Oct 9, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2019

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

Authorized official

Name
Christopher Sims
Title
Credentialing Manager
Phone
(470) 552-1823

Specialties & licenses 1

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

Addresses

Primary practice location

203 Millard Farmer Ind Blvd
Newnan, GA 30263-1012

Mailing address

203 Millard Farmer Ind Blvd
Newnan, GA 30263-1012
Phone (770) 253-3595

Other names 1

  • COWETA DENTISTRY ASSOCIATES Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Coweta Dentistry Associates4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

203 Millard Farmer Ind Blvd
Newnan, GA 30263
Phone (770) 253-3595

Practitioners & affiliated clinicians

Practitioners 10

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": "1570579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570579200000",
    "number": "1164064481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 MILLARD FARMER IND BLVD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302631012",
            "telephone_number": "770-253-3595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 MILLARD FARMER IND BLVD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302631012",
            "telephone_number": "770-253-3595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COWETA DENTISTRY SDA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-09",
        "last_updated": "2019-10-09",
        "status": "A",
        "authorized_official_last_name": "SIMS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "470-552-1823"
    },
    "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": "COWETA DENTISTRY ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; 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.