Organization Active NPI

Cherokee Family Dental, LLC

  • General Practice Dentistry
  • Canton, GA
National Provider Identifier
1194155986
Registry record updated Nov 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN013366 Issued in GA
Legal business name
CHEROKEE FAMILY DENTAL, LLC
Practice address
2920 Marietta Hwy
Suite 146
Canton, GA 30114-8212
Phone
(770) 704-6987
NPI assigned
Nov 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2013

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

Authorized official

Name
Dr. Nicholas Johnson, DMD
Title
Owner
Phone
(770) 704-6987

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X DN014617 GA
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X DN013366 GA Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X DN014219 GA

Addresses

Primary practice location

2920 Marietta Hwy
Suite 146
Canton, GA 30114-8212

Mailing address

2920 Marietta Highway
Suite 146
Canton, GA 30114

National Provider Directory

National Provider Directory

Locations

2920 Marietta Hwy
Ste 146
Canton, GA 30114
Phone (470) 253-7252

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": "1384473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384473600000",
    "number": "1194155986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 MARIETTA HIGHWAY",
            "address_2": "SUITE 146",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "30114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 MARIETTA HWY",
            "address_2": "SUITE 146",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301148212",
            "telephone_number": "770-704-6987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHEROKEE FAMILY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-15",
        "last_updated": "2013-11-15",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-704-6987",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "GA",
            "license": "DN014617",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013366",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN014219",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; 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.