NPIMap

Organization Active NPI

Comfort Dental Studio

  • General Practice Dentistry
  • Grayson, GA
National Provider Identifier
1306952122
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN012336 Issued in GA
Legal business name
COMFORT DENTAL STUDIO
Practice address
2219 Loganville Hwy
Grayson, GA 30017-1622
Phone
(678) 372-1800
Fax
(678) 377-0740
NPI assigned
Aug 22, 2006
Last updated
Dec 11, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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

Authorized official

Name
Dr. Alisa M Nelson, DDS
Title
President / Dentist
Phone
(678) 377-1800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN012336 GA Primary

Addresses

Primary practice location

2219 Loganville Hwy
Grayson, GA 30017-1622

Mailing address

2219 Loganville Hwy
Grayson, GA 30017-1622
Phone (678) 372-1800

National Provider Directory

National Provider Directory

Locations

2219 Loganville Hwy
Grayson, GA 30017
Phone (678) 372-1800

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": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355184000000",
    "number": "1306952122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 LOGANVILLE HWY",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300171622",
            "telephone_number": "678-372-1800",
            "fax_number": "678-377-0740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 LOGANVILLE HWY",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300171622",
            "telephone_number": "678-372-1800",
            "fax_number": "678-377-0740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORT DENTAL STUDIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2012-12-11",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "ALISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT / DENTIST",
        "authorized_official_telephone_number": "678-377-1800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayson, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2012; 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.