Professional Dental Alliance of Athens, LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PROFESSIONAL DENTAL ALLIANCE OF ATHENS, LLC

Practice address

1155 Cedar Shoals Dr
Athens, GA 30605-3592

Phone

(706) 546-8720

NPI assigned

Jan 16, 2019

Organization subpart

No

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

Authorized official

Name

Ashley Hamilton

Title

Revenue Cycle Support Specialist

Phone

(724) 698-2064

Specialties & licenses 1

Addresses

Practitioners 3

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

• Brandon Lee Esco, DMD

  • Dentist
  • Snellville, GA
  • NPI 1164724464
  NPD (past)
• James Benjamin Patrick, DMD

  • General Practice Dentistry
  • Athens, GA
  • NPI 1477696607
  NPD (past)
• Brant Sandifer, DMD

  • Dentist
  • Watkinsville, GA
  • NPI 1871014449
  NPD (past)

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

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708560000000",
    "number": "1174097802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 ENTERPRISE DR STE 200",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152751223",
            "telephone_number": "724-698-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 CEDAR SHOALS DR",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306053592",
            "telephone_number": "706-546-8720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL ALLIANCE OF ATHENS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-16",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "REVENUE CYCLE SUPPORT SPECIALIST",
        "authorized_official_telephone_number": "724-698-2064"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prince Avenue Primary Care, L.L.C.
• Janet Smith Prior, LPN
• Kim Pritchett
• Samantha Lee Ann Privett, AGACNP
• Alexandra Gale Probst
• Project Family LLC
• Promed Transport LLC
• Prosthetic Care, LLC
• Providence Counseling & Consulting, LLC
• Scott Provost, LDO

• Dentist in Athens, GA
• Providers in Athens, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.