NPIMap

Organization Active NPI

Conyers Smiles Dentistry, PC

Doing business as Conyers Smiles Dentistry

  • General Practice Dentistry
  • Conyers, GA
National Provider Identifier
1255734174
Registry record updated Oct 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CONYERS SMILES DENTISTRY, PC
Doing business as
Conyers Smiles Dentistry
Practice address
2239 Highway 20 SE
Suite H
Conyers, GA 30013-2091
Phone
(770) 921-3565
Fax
(770) 921-3534
NPI assigned
Oct 6, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2014

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

Authorized official

Name
Dr. Katie L McCann, DDS
Title
Owner
Phone
(770) 921-3565

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2239 Highway 20 SE
Suite H
Conyers, GA 30013-2091

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8890

Other names 1

  • Conyers Smiles Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

2239 Highway 20 SE
Ste H
Conyers, GA 30013
Phone (770) 570-6399

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412553600000",
    "number": "1255734174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2239 HIGHWAY 20 SE",
            "address_2": "SUITE H",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300132091",
            "telephone_number": "770-921-3565",
            "fax_number": "770-921-3534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONYERS SMILES DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-06",
        "last_updated": "2014-10-06",
        "status": "A",
        "authorized_official_last_name": "MCCANN",
        "authorized_official_first_name": "KATIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-921-3565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Conyers Smiles Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 6, 2014; 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.