Dentistry for Children of Austell, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

DENTISTRY FOR CHILDREN OF AUSTELL, LLC

Practice address

1678 Mulkey Rd
Ste D
Austell, GA 30106-1147

Phone

(678) 445-5444

Fax

(678) 445-5552

NPI assigned

Nov 5, 2010

Organization subpart

No

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

Authorized official

Name

Jeannine Bartch

Title

Manager

Phone

(678) 445-5444

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1288915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288915200000",
    "number": "1316248461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 195",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301880195",
            "telephone_number": "678-445-5444",
            "fax_number": "678-445-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1678 MULKEY RD",
            "address_2": "STE D",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061147",
            "telephone_number": "678-445-5444",
            "fax_number": "678-445-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTRY FOR CHILDREN OF AUSTELL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-05",
        "last_updated": "2010-11-05",
        "status": "A",
        "authorized_official_last_name": "BARTCH",
        "authorized_official_first_name": "JEANNINE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "678-445-5444"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Austell, GA
• Providers in Austell, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.