99 Mockingbird Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

99 MOCKINGBIRD DENTAL LLC

Practice address

99 Mockingbird Dr
Cartersville, GA 30120-2826

Phone

(770) 386-3908

NPI assigned

Sep 25, 2024

Last updated

Sep 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elijah Stephens, DMDNPI 1467894824

Title

Doctor/Owner

Phone

(912) 580-8511

Specialties & licenses 1

Addresses

Practitioners 3

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.

• Elijah Hoyt Stephens, D.M.D.

  • General Practice Dentistry
  • Canton, GA
  • NPI 1467894824
  NPD Authorized official
• Paul A. Eberhard, DDS

  • General Practice Dentistry
  • Cartersville, GA
  • NPI 1831191675
  NPD (past)
• Masoud Shoukoohi, DMD

  • Dentist
  • Cartersville, GA
  • NPI 1063659571
  NPD (past)

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

{
    "created_epoch": "1727222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1265259659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 NORTHAMPTON DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301156015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 MOCKINGBIRD DR",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202826",
            "telephone_number": "770-386-3908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "99 MOCKINGBIRD DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-25",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "ELIJAH",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "912-580-8511",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 100 Chiro Staples Cartersville PC
• 100 Percent Chiropractic Gibson LLC
• A Family Practice and Wellness Center
• A Healing Journey Counseling & Consultation
• Kimmie Aaron, NP
• Afu Mohammad Abdul, MD
• Absolute Care Ambulance Service

• General Practice Dentistry in Cartersville, GA
• Providers in Cartersville, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.