Lithonia Pediatric Dentistry-Stonecrest Inc

Primary specialty

DentistTaxonomy code 122300000X

License

DN013999 Issued in GA

Legal business name

LITHONIA PEDIATRIC DENTISTRY-STONECREST INC

Practice address

7215 Stonecrest Pkwy
Lithonia, GA 30038-2563

Phone

(770) 482-4661

Fax

(770) 482-4606

NPI assigned

Feb 12, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Young Tae Shim, D.M.D.

Title

Dentist

Phone

(770) 482-4661

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1360627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360627200000",
    "number": "1285973230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7215 STONECREST PKWY",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300382563",
            "telephone_number": "770-482-4661",
            "fax_number": "770-482-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7215 STONECREST PKWY",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300382563",
            "telephone_number": "770-482-4661",
            "fax_number": "770-482-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITHONIA PEDIATRIC DENTISTRY-STONECREST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-12",
        "last_updated": "2013-02-12",
        "status": "A",
        "authorized_official_last_name": "SHIM",
        "authorized_official_first_name": "YOUNG",
        "authorized_official_middle_name": "TAE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "770-482-4661",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN013999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gayle M Lindsay, OTR/L
• Janice Lindsay
• Lithonia Accident Care
• Lithonia Behavioral Health Inc
• Lithonia Family Eye Care LLC
• Lithonia Restorative and Cosmetic Dental Center
• Lithonia Woundcare Center
• Lithonia-Rockdale Dialysis, LLC (Renal Care Group Lithonia)
• Little Love Healthcare Services LLC
• Eboni Little

• Dentist in Lithonia, GA
• Providers in Lithonia, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; 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.