Homegrown Pediatric Dentistry and Orthodontics

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN014531 Issued in GA

Legal business name

HOMEGROWN PEDIATRIC DENTISTRY AND ORTHODONTICS

Practice address

405 Arrowhead Blvd
Jonesboro, GA 30236-1254

Phone

(770) 471-1991

NPI assigned

Nov 30, 2015

Organization subpart

No

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

Authorized official

Name

Christina McKellar

Title

Member/ Pediatric Dentist

Phone

(386) 212-6669

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1448841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448841600000",
    "number": "1225402373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 TIMBER LAKE DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300418606",
            "telephone_number": "386-212-6669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 ARROWHEAD BLVD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361254",
            "telephone_number": "770-471-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMEGROWN PEDIATRIC DENTISTRY AND ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-30",
        "last_updated": "2015-11-30",
        "status": "A",
        "authorized_official_last_name": "MCKELLAR",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "MEMBER/ PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "386-212-6669"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN014531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tasha Michelle Hines, OTRL
• Sheenequa Hinson
• Gary J Hirsch, PAC
• His Way Lifestyle and Education Center
• Okeri J Hollingshed
• Ninon F Honaker, CNP
• Deborah Travis Honeycutt, MD
• Raymond L Hoobler, PHD
• Sierra Hoskins
• Hospice of Divine Mercy Inc

• Pediatric Dentistry in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.