NPIMap

Organization Active NPI

Gwinnett Family Dental Care

  • Dentist
  • Lawrenceville, GA
National Provider Identifier
1316112360
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
GA11839 Issued in GA
Legal business name
GWINNETT FAMILY DENTAL CARE
Practice address
3455 Lawrenceville Hwy
Lawrenceville, GA 30044-4101
Phone
(770) 921-1115
Fax
(770) 564-3856
NPI assigned
Apr 29, 2008
Last updated
Apr 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Authorized official

Name
Dr. Kell D. Gallaher, DMD
Title
Owner
Phone
(770) 921-1115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X GA11839 GA Primary

Addresses

Primary practice location

3455 Lawrenceville Hwy
Lawrenceville, GA 30044-4101

Mailing address

3455 Lawrenceville Hwy
Lawrenceville, GA 30044-4101
Phone (770) 921-1115

National Provider Directory

National Provider Directory

Locations

3455 Lawrenceville Hwy
Lawrenceville, GA 30044
Phone (770) 921-1115

Practitioners & affiliated clinicians

Practitioners 9

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": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209513600000",
    "number": "1316112360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 LAWRENCEVILLE HWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300444101",
            "telephone_number": "770-921-1115",
            "fax_number": "770-564-3856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 LAWRENCEVILLE HWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300444101",
            "telephone_number": "770-921-1115",
            "fax_number": "770-564-3856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GWINNETT FAMILY DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-04-30",
        "status": "A",
        "authorized_official_last_name": "GALLAHER",
        "authorized_official_first_name": "KELL",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-921-1115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "GA11839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; 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.