Southern Smiles Newnan

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SOUTHERN SMILES NEWNAN

Practice address

354 Bullsboro Dr Unit 4
Newnan, GA 30263-1069

Phone

(770) 683-9622

NPI assigned

May 17, 2022

Last updated

May 17, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Justin Adler

Title

Partner

Phone

(404) 784-8659

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652745600000",
    "number": "1225775760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 HOLCOMB BRIDGE RD STE 224",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300225976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 BULLSBORO DR UNIT 4",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302631069",
            "telephone_number": "770-683-9622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SMILES NEWNAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-17",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A",
        "authorized_official_last_name": "ADLER",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "404-784-8659"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "newnan@southernsmilesgroup.com",
            "affiliation": "N",
            "address_1": "354 Bullsboro Dr Unit 4",
            "city": "Newnan",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302631069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Dental Clinic/Center in Newnan, GA
• Providers in Newnan, GA by specialty
• Dental Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; 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.