Savannah Dental Group, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

09617 Issued in GA

Legal business name

SAVANNAH DENTAL GROUP, LLC

Practice address

5509 Paulsen St
Savannah, GA 31405-4902

Phone

(912) 354-9204

NPI assigned

Jan 13, 2012

Last updated

Jan 13, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brian Beaudreau, D.M.D.NPI 1689741118

Title

Owner

Phone

(912) 354-9204

Specialties & licenses 1

Addresses

Other names 1

• Brian Beaudreau, LLC Former legal business name

Locations

Practitioners 3

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.

• Brian Douglas Beaudreau, D.M.D.

  • General Practice Dentistry
  • Savannah, GA
  • NPI 1689741118
  NPD (past) Authorized official
• Christian Rosario Patti, DMD

  • General Practice Dentistry
  • Savannah, GA
  • NPI 1013279462
  NPD (past)
• William Stephen Ray Jr., D.D.S.

  • General Practice Dentistry
  • Savannah, GA
  • NPI 1013289891
  NPD (past)

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

{
    "created_epoch": "1326412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326412800000",
    "number": "1164793741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5509 PAULSEN ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054902",
            "telephone_number": "912-354-9204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5509 PAULSEN ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054902",
            "telephone_number": "912-354-9204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAVANNAH DENTAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-13",
        "last_updated": "2012-01-13",
        "status": "A",
        "authorized_official_last_name": "BEAUDREAU",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-354-9204",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "09617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brian Beaudreau, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Savannah Clinic Inc. (Savannah Chiropractic Center)
• Savannah Counseling & Wellness, LLC
• Savannah Counseling & Wellness, LLC
• Savannah Crossing of Journey LLC
• Savannah Dental Associates,P.C.
• Savannah Diabetic Supplies, Inc.
• Savannah Diagnostic Assoc PC
• Savannah Endocrine & Diabetes P.C.
• Savannah Endocrinology LLC
• Savannah Endoscopy Center, LLC

• General Practice Dentistry in Savannah, GA
• Providers in Savannah, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.