NPIMap

Organization Active NPI

Dental Professionals of Georgia, P.C.

  • General Practice Dentistry
  • Lagrange, GA
National Provider Identifier
1235674227
Registry record updated Dec 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF GEORGIA, P.C.
Doing business as
Calumet Family Dentistry
Practice address
116 Calumet Center Rd
Lagrange, GA 30241-6703
Phone
(706) 882-2937
NPI assigned
Dec 29, 2016
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF GEORGIA, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 29, 2016

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

Authorized official

Name
Cassandra Teutsch
Title
Credentialing Coordinator
Phone
(217) 540-8972

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

116 Calumet Center Rd
Lagrange, GA 30241-6703

Mailing address

116 Calumet Center Rd
Lagrange, GA 30241-6703
Phone (706) 882-2937

Other names 1

  • Calumet Family Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of Georgia PC6 organizations share this tax ID, including this one
Part of
Dental Professionals of Georgia PC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

116 Calumet Center Rd
Lagrange, GA 30241
Phone (706) 882-2937

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1482969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482969600000",
    "number": "1235674227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 CALUMET CENTER RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302416703",
            "telephone_number": "706-882-2937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 CALUMET CENTER RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302416703",
            "telephone_number": "706-882-2937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF GEORGIA, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF GEORGIA, P.C.",
        "enumeration_date": "2016-12-29",
        "last_updated": "2016-12-29",
        "status": "A",
        "authorized_official_last_name": "TEUTSCH",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8972"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Calumet Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lagrange, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; 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.