Stockbridge Dental Smiles 2 LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

STOCKBRIDGE DENTAL SMILES 2 LLC

Practice address

175 Country Club Dr BLDG 300B
Stockbridge, GA 30281-7388

Phone

(678) 565-9452

NPI assigned

Aug 27, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Praveen Gudipati, D.M.D.

Title

Owner

Phone

(770) 205-0466

Specialties & licenses 1

Addresses

Other names 2

• CUMMING DENTAL SMILES Doing business as
• STOCKBRIDGE DENTAL SMILES Doing business as

Locations

Practitioners 2

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

• Pravin Shah

  • General Practice Dentistry
  • Stockbridge, GA
  • NPI 1922811637
  NPD
• Heather Victorine

  • Dentist
  • Stockbridge, GA
  • NPI 1912054917
  NPD

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

{
    "created_epoch": "1756252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756252800000",
    "number": "1295614121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 AZALEA BLUFF DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300413207",
            "telephone_number": "404-966-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 COUNTRY CLUB DR BLDG 300B",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817388",
            "telephone_number": "678-565-9452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOCKBRIDGE DENTAL SMILES 2 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-27",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A",
        "authorized_official_last_name": "GUDIPATI",
        "authorized_official_first_name": "PRAVEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-205-0466",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CUMMING DENTAL SMILES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "STOCKBRIDGE DENTAL SMILES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jamari Stewart
• Susan Ann Stewart, LPC
• Briana Stith, PA-C
• Stockbridge Dental Group
• Stockbridge Dental LLC
• Stockbridge Dental Smiles LLC
• Stockbridge Dialysis Clinic, LLC
• Stockbridge Family Care Center
• Stockbridge Family Dental Group PC
• Stockbridge Family Dental Group PC

• General Practice Dentistry in Stockbridge, GA
• Providers in Stockbridge, 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 Aug 27, 2025; 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.