NPIMap

Organization Active NPI

Heavenly Dental Associates

  • Dentist
  • Covington, GA
National Provider Identifier
1225299068
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN012304 Issued in GA
Legal business name
HEAVENLY DENTAL ASSOCIATES
Practice address
3162 Elm St NE
Covington, GA 30014-2461
Phone
(678) 625-7505
Fax
(678) 625-0207
NPI assigned
Jun 24, 2008
Last updated
Jun 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Authorized official

Name
Dr. Heavenly E Kimes, DDS
Title
Owner
Phone
(678) 625-7505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN012304 GA Primary

Addresses

Primary practice location

3162 Elm St NE
Covington, GA 30014-2461

Mailing address

3162 Elm St NE
Covington, GA 30014-2461
Phone (678) 625-7505

National Provider Directory

National Provider Directory
Tax ID family
Heavenly Assisted Care LLC2 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.

NPI Registry JSON

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1225299068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3162 ELM ST NE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300142461",
            "telephone_number": "678-625-7505",
            "fax_number": "678-625-0207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3162 ELM ST NE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300142461",
            "telephone_number": "678-625-7505",
            "fax_number": "678-625-0207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-24",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "KIMES",
        "authorized_official_first_name": "HEAVENLY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-625-7505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN012304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, GA

Sources for this page

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