Fabulous Smiles of Lilburn

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

DN011973 Issued in GA

Legal business name

FABULOUS SMILES OF LILBURN

Practice address

331 Arcado Rd NW
Lilburn, GA 30047-3077

Phone

(770) 557-0788

Fax

(404) 420-2951

NPI assigned

Jul 21, 2015

Organization subpart

No

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

Authorized official

Name

Nikki Rolls

Title

Office Manager

Phone

(770) 557-0788

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1437436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437436800000",
    "number": "1205211133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 ARCADO RD NW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473077",
            "telephone_number": "770-557-0788",
            "fax_number": "404-420-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 ARCADO RD NW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473077",
            "telephone_number": "770-557-0788",
            "fax_number": "404-420-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FABULOUS SMILES OF LILBURN",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-21",
        "last_updated": "2015-07-21",
        "status": "A",
        "authorized_official_last_name": "ROLLS",
        "authorized_official_first_name": "NIKKI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-557-0788"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "GA",
            "license": "DN011973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dinessa N Everhart
• Tiffany Naikia Expose
• Ijeoma Ezeobele, DFM, DHM
• Joy Ijeoma Ezeokonkwo
• Fabulous Dentistry and Orthodontic PC
• Face Down Ga
• Patricia Joan Facey
• Faith M. Gray, M.D., Inc.
• Faith Non Emerency Medical Transport LLC
• Familia Dentistry of Georgia, LLC

• Point of Service in Lilburn, GA
• Providers in Lilburn, GA by specialty
• Point of Service in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; 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.