Stone Mountain Dental PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

STONE MOUNTAIN DENTAL PC

Practice address

4813 Rockbridge Rd Ste 26
Stone Mountain, GA 30083-4200

Phone

(404) 292-9838

Fax

(404) 292-8344

NPI assigned

Mar 24, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Schadale StevensNPI 1386798346

Title

Ownerr

Phone

(404) 292-8383

Specialties & licenses 1

Addresses

Tax ID family

Stone Mountain Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Stone Mountain Dental

  • Health Maintenance Organization
  • Stone Mountain, GA
  • NPI 1992958722
  NPD tax ID

Practitioners 1

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

• Schadale Stevens, D.D.S

  • General Practice Dentistry
  • Stone Mountain, GA
  • NPI 1386798346
  NPD (past) Authorized official

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1194997726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4813 ROCKBRIDGE RD STE 26",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300834200",
            "telephone_number": "404-292-9838",
            "fax_number": "404-292-8344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4813 ROCKBRIDGE RD STE 26",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300834200",
            "telephone_number": "404-292-9838",
            "fax_number": "404-292-8344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONE MOUNTAIN DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "SCHADALE",
        "authorized_official_title_or_position": "OWNERR",
        "authorized_official_telephone_number": "404-292-8383",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rena Stewart, DNP
• Trina Lorraine Stewart, PHARM.D.
• Stone Mountain
• Stone Mountain Christian Counseling Services Inc
• Stone Mountain Dental
• Stone Mountain Dialysis Center, LLC
• Stone Mountain Eye Center
• Stone Mountain Eyecare LLC
• Stone Mountain Family Medicine PC
• Stone Mountain Family Practice, PC

• General Practice Dentistry in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.