NPIMap

Organization Active NPI

Duluth Dental Services PC

  • Dentist
  • Duluth, GA
National Provider Identifier
1184782575
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9930 Issued in GA
Legal business name
DULUTH DENTAL SERVICES PC
Practice address
2785 Buford Highway
Building B Suite 101 Duluth Dental Services
Duluth, GA 30096-2866
Phone
(770) 476-3332
Fax
(770) 622-1577
NPI assigned
Dec 5, 2006
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. Thomas E Geoghegan, DDSNPI 1154669406
Title
Dentist
Phone
(770) 476-3332

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 9930 GA Primary

Addresses

Primary practice location

2785 Buford Highway
Building B Suite 101 Duluth Dental Services
Duluth, GA 30096-2866

Mailing address

2785 Buford Highway
Building B Suite 101
Duluth, GA 30096-2866
Phone (770) 476-3332

National Provider Directory

National Provider Directory

Locations

2785 Buford Hwy
Bldg B
Duluth, GA 30096
Phone (770) 476-3332

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": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184782575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2785 BUFORD HIGHWAY",
            "address_2": "BUILDING B SUITE 101",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300962866",
            "telephone_number": "770-476-3332",
            "fax_number": "770-622-1577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2785 BUFORD HIGHWAY",
            "address_2": "BUILDING B SUITE 101 DULUTH DENTAL SERVICES",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300962866",
            "telephone_number": "770-476-3332",
            "fax_number": "770-622-1577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DULUTH DENTAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GEOGHEGAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "770-476-3332",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "9930",
            "primary": true
        }
    ],
    "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 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.