Park Village Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

012497 Issued in GA

Legal business name

PARK VILLAGE DENTAL GROUP

Practice address

2550 Pleasant Hill Rd
Suite #115
Duluth, GA 30096-4122

Phone

(770) 814-7791

Fax

(770) 814-7792

NPI assigned

Jun 7, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Nancy Ahn

Title

Office Manager

Phone

(770) 814-7791

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Jay H Ahn, DMD

  • Dentist
  • Duluth, GA
  • NPI 1477741437
  NPD (past)

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339027200000",
    "number": "1225399082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 PLEASANT HILL RD",
            "address_2": "SUITE #115",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964122",
            "telephone_number": "770-814-7791",
            "fax_number": "770-814-7792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 PLEASANT HILL RD",
            "address_2": "SUITE #115",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964122",
            "telephone_number": "770-814-7791",
            "fax_number": "770-814-7792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK VILLAGE DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-07",
        "last_updated": "2012-06-07",
        "status": "A",
        "authorized_official_last_name": "AHN",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-814-7791",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "012497",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "013551",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Palmetto Infusion Services LLC
• James Andrew Palmier, M.D.
• Destiny Lanise Palmore
• Amy J Pancake, RPH
• Amar Parikh, M.D.
• Anny Park, MSN, APRN, FNP-C
• Cecilia Park, FNP
• Chuel-Hong Park, D.C. B.C.A.O
• Hojun Park, OMD
• Hyun Ho Park

• General Practice Dentistry in Duluth, GA
• Providers in Duluth, 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 Jun 7, 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.