NPIMap

Organization Active NPI

East Cobb Family Dentistry, P.C.

  • General Practice Dentistry
  • Marietta, GA
National Provider Identifier
1184650350
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10725 Issued in GA
Legal business name
EAST COBB FAMILY DENTISTRY, P.C.
Practice address
2969 Johnson Ferry Rd
Marietta, GA 30062-5653
Phone
(770) 992-2340
Fax
(770) 587-0240
NPI assigned
Jun 23, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. David C. Haydon, DDSNPI 1104853894
Title
President
Phone
(770) 992-2340

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10725 GA Primary

Addresses

Primary practice location

2969 Johnson Ferry Rd
Marietta, GA 30062-5653

Mailing address

2969 Johnson Ferry Rd
Marietta, GA 30062-5653
Phone (770) 992-2340

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184650350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2969 JOHNSON FERRY RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625653",
            "telephone_number": "770-992-2340",
            "fax_number": "770-587-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2969 JOHNSON FERRY RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625653",
            "telephone_number": "770-992-2340",
            "fax_number": "770-587-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST COBB FAMILY DENTISTRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAYDON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-992-2340",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "10725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.