NPIMap

Organization Active NPI

Smile Dental Group of Conyers PC

  • Dental Clinic/Center
  • Conyers, GA
National Provider Identifier
1235117375
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
SMILE DENTAL GROUP OF CONYERS PC
Practice address
1816 Lakefield CT
Conyers, GA 30013
Phone
(770) 860-8760
Fax
(770) 760-1375
NPI assigned
Jan 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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

Authorized official

Name
Paul Spurgeon
Title
Credentialing Supervisor
Phone
(888) 833-8441

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1816 Lakefield CT
Conyers, GA 30013

Mailing address

1816 Lakefield CT SE
Conyers, GA 30013-6609
Phone (770) 860-8760

National Provider Directory

National Provider Directory

Locations

1816 Lakefield Ct SE
Conyers, GA 30013
Phone (770) 860-8760

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785369600000",
    "number": "1235117375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 LAKEFIELD CT SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136609",
            "telephone_number": "770-860-8760",
            "fax_number": "770-760-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1816 LAKEFIELD CT",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "30013",
            "telephone_number": "770-860-8760",
            "fax_number": "770-760-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE DENTAL GROUP OF CONYERS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-09",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A",
        "authorized_official_last_name": "SPURGEON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "888-833-8441"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2026; 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.