NPIMap

Organization Active NPI

Colton Dental Group

  • Dental Clinic/Center
  • Austell, GA
National Provider Identifier
1245779792
Registry record updated Feb 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DN013527 Issued in GA
Legal business name
COLTON DENTAL GROUP
Practice address
2495 East-West Connector
Ste 60
Austell, GA 30106
Phone
(678) 384-1020
NPI assigned
Feb 16, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2017

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

Authorized official

Name
Mrs. Teresa Tard
Title
Business Manager
Phone
(678) 384-1020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DN013527 GA Primary

Addresses

Primary practice location

2495 East-West Connector
Ste 60
Austell, GA 30106

Mailing address

2495 East-West Connector
Ste 60
Austell, GA 30106
Phone (678) 384-1020

Other names 1

  • east west family dental Doing business as

National Provider Directory

National Provider Directory

Locations

2495 E West Connector
Ste 60
Austell, GA 30106
Phone (678) 384-1020

Practitioners & affiliated clinicians

Practitioners 1

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": "1487203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1245779792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2495 EAST-WEST CONNECTOR",
            "address_2": "STE 60",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "30106",
            "telephone_number": "678-384-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 EAST-WEST CONNECTOR",
            "address_2": "STE 60",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "30106",
            "telephone_number": "678-384-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLTON DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-16",
        "last_updated": "2017-02-16",
        "status": "A",
        "authorized_official_last_name": "TARD",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "678-384-1020",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "GA",
            "license": "DN013527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "east west family dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 16, 2017; 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.