NPIMap

Organization Active NPI

Grace S. Gavric, DDS, LLC.

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1295066892
Registry record updated Mar 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN013138 Issued in GA
Legal business name
GRACE S. GAVRIC, DDS, LLC.
Practice address
1100 Circle 75 Pkwy SE
Suite 200
Atlanta, GA 30339-3064
Phone
(770) 980-0558
Fax
(770) 980-1092
NPI assigned
Jan 20, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2010

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

Authorized official

Name
Dr. Grace Susan Gavric, D.D.S.NPI 1588705925
Title
President/Operating Manager
Phone
(770) 980-0558

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN013138 GA Primary

Addresses

Primary practice location

1100 Circle 75 Pkwy SE
Suite 200
Atlanta, GA 30339-3064

Mailing address

1100 Circle 75 Pkwy SE
Suite 200
Atlanta, GA 30339-3064
Phone (770) 980-0558

Other names 1

  • Kerr & Gavric Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

1100 Circle 75 Pkwy SE
Ste 200
Atlanta, GA 30339
Phone (770) 980-0558

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269820800000",
    "number": "1295066892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 CIRCLE 75 PKWY SE",
            "address_2": "SUITE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393064",
            "telephone_number": "770-980-0558",
            "fax_number": "770-980-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CIRCLE 75 PKWY SE",
            "address_2": "SUITE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393064",
            "telephone_number": "770-980-0558",
            "fax_number": "770-980-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE S. GAVRIC, DDS, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-20",
        "last_updated": "2010-03-29",
        "status": "A",
        "authorized_official_last_name": "GAVRIC",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "SUSAN",
        "authorized_official_title_or_position": "PRESIDENT/OPERATING MANAGER",
        "authorized_official_telephone_number": "770-980-0558",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kerr & Gavric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.