Organization Active NPI

Ideal Dental Cumming PC

  • Dentist
  • Cumming, GA
National Provider Identifier
1194448035
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
IDEAL DENTAL CUMMING PC
Practice address
884 Buford Rd
Cumming, GA 30041-2716
Phone
(770) 406-2400
Fax
(770) 758-0019
NPI assigned
Sep 26, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Authorized official

Name
Rodney Alles, DDS
Title
Owner
Phone
(972) 331-8079

Specialties & licenses 1

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

Addresses

Primary practice location

884 Buford Rd
Cumming, GA 30041-2716

Mailing address

PO Box 840925
Dallas, TX 75284-0925

National Provider Directory

National Provider Directory

Locations

884 Buford Rd
Cumming, GA 30041
Phone (470) 768-7825

NPI Registry JSON

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696204800000",
    "number": "1194448035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840925",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "884 BUFORD RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300412716",
            "telephone_number": "770-406-2400",
            "fax_number": "770-758-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL DENTAL CUMMING PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-26",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A",
        "authorized_official_last_name": "ALLES",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-331-8079",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.