Active NPI
Childrens Dentistry of Austell
- Pediatric Dentistry
- Austell, GA
National Provider Identifier
1235298274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- Legal business name
- CHILDRENS DENTISTRY OF AUSTELL
- Practice address
- 1678 Mulkey Rd
Ste D
Austell, GA 30106 - Phone
- (678) 445-5444
- Fax
- (678) 445-5552
- NPI assigned
- Dec 6, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brian Smith
- Title
- Controller
- Phone
- (678) 445-5444
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | GA | Primary |
Addresses
Primary practice location
1678 Mulkey Rd
Ste D
Austell, GA 30106
Mailing address
PO Box 195
Woodstock, GA 30188
Phone (678) 445-5444
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1235298274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 195",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "30188",
"telephone_number": "678-445-5444",
"fax_number": "678-445-5552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1678 MULKEY RD",
"address_2": "STE D",
"city": "AUSTELL",
"state": "GA",
"postal_code": "30106",
"telephone_number": "678-445-5444",
"fax_number": "678-445-5552"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHILDRENS DENTISTRY OF AUSTELL",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-06",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "SMITH",
"authorized_official_first_name": "BRIAN",
"authorized_official_title_or_position": "CONTROLLER",
"authorized_official_telephone_number": "678-445-5444"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": "GA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.