NPIMap

Organization Active NPI

MH Dental PC

  • General Practice Dentistry
  • Norcross, GA
National Provider Identifier
1164640801
Registry record updated Jul 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MH DENTAL PC
Practice address
6000 Singleton Rd
Ste 315
Norcross, GA 30093
Phone
(770) 248-9029
Fax
(770) 248-9130
NPI assigned
Apr 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2012

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

Authorized official

Name
Crystal G. Walker
Title
Collections Manager
Phone
(770) 367-8389

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

6000 Singleton Rd
Ste 315
Norcross, GA 30093

Mailing address

1030A West Gordon Ave
Albany, GA 31701
Phone (770) 248-9029

Other identifiers 1

IdentifierTypeStateIssuer
714338776BMedicaidGA

Other names 1

  • Vital Smiles Georgia Doing business as

National Provider Directory

National Provider Directory
Tax ID family
MH Dental PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

6000 Singleton Rd
Ste 315
Norcross, GA 30093
Phone (770) 248-9029

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343088000000",
    "number": "1164640801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030A WEST GORDON AVE",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "31701",
            "telephone_number": "770-248-9029",
            "fax_number": "770-248-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 SINGLETON RD",
            "address_2": "STE 315",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "30093",
            "telephone_number": "770-248-9029",
            "fax_number": "770-248-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MH DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2012-07-24",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "COLLECTIONS MANAGER",
        "authorized_official_telephone_number": "770-367-8389"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "714338776B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vital Smiles Georgia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.