NPIMap

Organization Active NPI

Georgia Dental Clinic, P.C.

Doing business as East Cobb Dental Care

  • General Practice Dentistry
  • Marietta, GA
National Provider Identifier
1306159926
Registry record updated Jul 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DL013756 Issued in GA
Legal business name
GEORGIA DENTAL CLINIC, P.C.
Doing business as
East Cobb Dental Care
Practice address
2860 Johnson Ferry Rd
Suite 100
Marietta, GA 30062-8339
Phone
(770) 998-5290
Fax
(770) 552-4795
NPI assigned
Jul 24, 2010
Last updated
Jul 24, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2010

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

Authorized official

Name
Dr. Charles Chung, D.M.D.NPI 1023279882
Title
President
Phone
(770) 998-5290

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DL013756 GA Primary

Addresses

Primary practice location

2860 Johnson Ferry Rd
Suite 100
Marietta, GA 30062-8339

Mailing address

2860 Johnson Ferry Rd
Suite 100
Marietta, GA 30062-8339
Phone (770) 998-5290

Other names 1

  • East Cobb Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

2860 Johnson Ferry Rd
Ste 100
Marietta, GA 30062
Phone (770) 998-5290

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1279929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279929600000",
    "number": "1306159926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 JOHNSON FERRY RD",
            "address_2": "SUITE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300628339",
            "telephone_number": "770-998-5290",
            "fax_number": "770-552-4795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 JOHNSON FERRY RD",
            "address_2": "SUITE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300628339",
            "telephone_number": "770-998-5290",
            "fax_number": "770-552-4795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA DENTAL CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-24",
        "last_updated": "2010-07-24",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-998-5290",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DL013756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Cobb Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.