NPIMap

Organization Active NPI

Georgia Dental Associates, LLC

  • Dental Clinic/Center
  • Bainbridge, GA
National Provider Identifier
1265072193
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
GEORGIA DENTAL ASSOCIATES, LLC
Practice address
500 Amelia Ave
Bainbridge, GA 39819-4356
Phone
(229) 246-3023
Fax
(229) 246-0073
NPI assigned
Jan 8, 2020
Last updated
Feb 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
GEORGIA DENTAL ASSOCIATES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Authorized official

Name
Nettie S Hatcher
Title
Director of Operations
Phone
(229) 848-2685

Specialties & licenses 1

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

Addresses

Primary practice location

500 Amelia Ave
Bainbridge, GA 39819-4356

Mailing address

500 Amelia Ave
Bainbridge, GA 39819-4356
Phone (229) 246-3023

National Provider Directory

National Provider Directory
Tax ID family
Georgia Dental Associates LLC6 organizations share this tax ID, including this one
Part of
Georgia Dental Associates LLC

Other organizations with this tax ID 5

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

Locations

500 Amelia Ave
Bainbridge, GA 39819
Phone (229) 246-3023

NPI Registry JSON

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

{
    "created_epoch": "1578441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645401600000",
    "number": "1265072193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 AMELIA AVE",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194356",
            "telephone_number": "229-246-3023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 AMELIA AVE",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194356",
            "telephone_number": "229-246-3023",
            "fax_number": "229-246-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA DENTAL ASSOCIATES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORGIA DENTAL ASSOCIATES, LLC",
        "enumeration_date": "2020-01-08",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A",
        "authorized_official_last_name": "HATCHER",
        "authorized_official_first_name": "NETTIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "229-848-2685"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; 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.