NPIMap

Organization Active NPI

Children and Teen Dental Group

  • General Practice Dentistry
  • Stone Mountain, GA
National Provider Identifier
1184584666
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CHILDREN AND TEEN DENTAL GROUP
Practice address
5500 Lilburn Stone Mountain Rd Ste a
Stone Mountain, GA 30087-2873
Phone
(770) 923-5500
NPI assigned
Nov 17, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Authorized official

Name
Brian Smith
Title
President
Phone
(470) 750-4866

Specialties & licenses 1

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

Addresses

Primary practice location

5500 Lilburn Stone Mountain Rd Ste a
Stone Mountain, GA 30087-2873

Mailing address

2300 Lakeview Pkwy Ste 250
Alpharetta, GA 30009-3954
Phone (470) 207-3264

National Provider Directory

National Provider Directory
Tax ID family
Children and Teen Dental Group8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

5500 Lilburn Stone Mountain Rd
Ste A
Stone Mountain, GA 30087
Phone (770) 923-5500

NPI Registry JSON

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

{
    "created_epoch": "1763337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783382400000",
    "number": "1184584666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 LAKEVIEW PKWY STE 250",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300093954",
            "telephone_number": "470-207-3264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 LILBURN STONE MOUNTAIN RD STE A",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300872873",
            "telephone_number": "770-923-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN AND TEEN DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-17",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "470-750-4866"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.