NPIMap

Organization Active NPI

Duluth Dental Associates

  • Dentist
  • Duluth, GA
National Provider Identifier
1184760753
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13018 Issued in GA
Legal business name
DULUTH DENTAL ASSOCIATES
Practice address
3415 B E Lawrenceville St
Duluth, GA 30096
Phone
(678) 412-7709
Fax
(678) 417-7071
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Authorized official

Name
Patricia Ann Rittgers
Title
Office Manager
Phone
(678) 417-7709

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 13018 GA Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 12813 GA

Addresses

Primary practice location

3415 B E Lawrenceville St
Duluth, GA 30096

Mailing address

3415 Duluth Hwy 120
#B
Duluth, GA 30096
Phone (678) 412-7709

National Provider Directory

National Provider Directory

Locations

3415B Duluth Highway 120
Duluth, GA 30096
Phone (678) 417-7709

3415 Duluth Highway 120
#B
Duluth, GA 30096

3415B E Lawrenceville St
Duluth, GA 30096
Phone (678) 412-7709

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1184760753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 DULUTH HWY 120",
            "address_2": "#B",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30096",
            "telephone_number": "678-412-7709",
            "fax_number": "628-417-7071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 B E LAWRENCEVILLE ST",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30096",
            "telephone_number": "678-412-7709",
            "fax_number": "678-417-7071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DULUTH DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "RITTGERS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "678-417-7709"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "13018",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "12813",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.