NPIMap

Organization Active NPI

Decatur Dental Center

  • Dentist
  • Decatur, GA
National Provider Identifier
1255653366
Registry record updated Feb 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11863 Issued in GA
Legal business name
DECATUR DENTAL CENTER
Doing business as
Decatur Dental Center
Practice address
3521 Memorial Dr
Suite a
Decatur, GA 30032-2731
Phone
(404) 567-8485
Fax
(404) 567-8487
NPI assigned
Feb 17, 2010
Last updated
Feb 17, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2010

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

Authorized official

Name
Abbas Haider, D.D.S.NPI 1245432004
Title
Owner
Phone
(404) 567-8485

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11863 GA Primary

Addresses

Primary practice location

3521 Memorial Dr
Suite a
Decatur, GA 30032-2731

Mailing address

3521 Memorial Dr
Suite a
Decatur, GA 30032-2731
Phone (404) 567-8485

Other names 1

  • Decatur Dental Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1266364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266364800000",
    "number": "1255653366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3521 MEMORIAL DR",
            "address_2": "SUITE A",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300322731",
            "telephone_number": "404-567-8485",
            "fax_number": "404-567-8487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3521 MEMORIAL DR",
            "address_2": "SUITE A",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300322731",
            "telephone_number": "404-567-8485",
            "fax_number": "404-567-8487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-17",
        "last_updated": "2010-02-17",
        "status": "A",
        "authorized_official_last_name": "HAIDER",
        "authorized_official_first_name": "ABBAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-567-8485",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "11863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Decatur Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; 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.