Milton Pediatric Dentistry and Orthodontics Corp

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN013057 Issued in GA

Legal business name

MILTON PEDIATRIC DENTISTRY AND ORTHODONTICS CORP

Practice address

980 Birmingham Rd Ste 507
Milton, GA 30004-4418

Phone

(678) 352-1090

NPI assigned

May 17, 2012

Organization subpart

No

Name

Dr. Vishant Nath, DMD

Title

Owner

Phone

(678) 763-2600

Locations

• Dentistry at MIlton Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 4, 2012.

{
    "created_epoch": "1337212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338768000000",
    "number": "1205196870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 W CROSSVILLE RD STE 203",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300757517",
            "telephone_number": "678-763-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 BIRMINGHAM RD STE 507",
            "city": "MILTON",
            "state": "GA",
            "postal_code": "300044418",
            "telephone_number": "678-352-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILTON PEDIATRIC DENTISTRY AND ORTHODONTICS CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-17",
        "last_updated": "2012-06-04",
        "status": "A",
        "authorized_official_last_name": "NATH",
        "authorized_official_first_name": "VISHANT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-763-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "761564386",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dentistry at MIlton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carrie Colcord McClure, PT, DPT
• Cara McDonald
• Darlene Alexandra McNulty, D.O.
• Anne Merrill, MFT
• Cobie C Miley, M.A. BCBA, LBA
• Milton Physical Therapy, LLC
• Ethan Minkert
• Katherine Mitchell, RN
• Jemicah Mosby
• Nirupama Arkonam Natarajan, MD

• All providers in Milton, GA
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2012; 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.