Organization Active NPI

Leading Edge Dentistry LLC

Doing business as Leading Edge Dentistry

  • Dental Clinic/Center
  • Marietta, GA
National Provider Identifier
1184369035
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
LEADING EDGE DENTISTRY LLC
Doing business as
Leading Edge Dentistry
Practice address
3475 Dallas Hwy SW
Suite No 310
Marietta, GA 30064-6405
Phone
(770) 425-2001
Fax
(770) 425-8696
NPI assigned
May 4, 2022
Last updated
Jul 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Authorized official

Name
Dr. Dimple Patel, DMD
Title
Owner
Phone
(770) 425-2001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

3475 Dallas Hwy SW
Suite No 310
Marietta, GA 30064-6405

Mailing address

3475 Dallas Hwy SW Ste 310
Marietta, GA 30064-6413
Phone (770) 425-2001

Other names 1

  • Leading Edge Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

3475 Dallas Hwy SW
Ste 310
Marietta, GA 30064
Phone (770) 425-2001

Practitioners & affiliated clinicians

Practitioners 1

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": "1651622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690156800000",
    "number": "1184369035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3475 DALLAS HWY SW STE 310",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300646413",
            "telephone_number": "770-425-2001",
            "fax_number": "770-425-8696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 DALLAS HWY SW",
            "address_2": "SUITE NO 310",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300646405",
            "telephone_number": "770-425-2001",
            "fax_number": "770-425-8696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEADING EDGE DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-04",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "DIMPLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-425-2001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Leading Edge Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Leading Edge Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.