Children's Dentistry of Lithonia, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN013400 Issued in GA

Legal business name

CHILDREN'S DENTISTRY OF LITHONIA, LLC

Doing business as

Children's Dentistry of Lawrenceville

Practice address

4850 Sugarloaf Parkway
Ste 611
Lawrenceville, GA 30044

Phone

(470) 299-3999

Fax

(678) 691-9589

NPI assigned

Apr 18, 2018

Last updated

Apr 18, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

CHILDREN'S DENTISTRY OF LITHONIA, LLCAs reported in NPPES

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

Authorized official

Name

Mr. Adesegun Olushola Tewogbade, DMD

Title

Pediatric Dentist/Owner

Phone

(770) 584-5267

Specialties & licenses 1

Addresses

Other names 1

• Children's Dentistry of Lawrenceville Doing business as

Tax ID family

Childrens Dentistry of Lithonia LLC2 organizations share this tax ID, including this one

Part of

Childrens Dentistry of Lithonia LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Childrens Dentistry of Lithonia LLC

  • Dental Clinic/Center
  • Stone Mountain, GA
  • NPI 1730348210
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Children's Dentistry of Lithonia LLC

  • Pediatrics Physician
  • Lithonia, GA
  • NPI 1972442747
  NPPES parent name

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524009600000",
    "number": "1316434095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 SUGARLOAF PARKWAY",
            "address_2": "STE 611",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30044",
            "telephone_number": "470-299-3999",
            "fax_number": "678-691-9589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 SUGARLOAF PARKWAY",
            "address_2": "STE 611",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30044",
            "telephone_number": "470-299-3999",
            "fax_number": "678-691-9589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S DENTISTRY OF LITHONIA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDREN'S DENTISTRY OF LITHONIA, LLC",
        "enumeration_date": "2018-04-18",
        "last_updated": "2018-04-18",
        "status": "A",
        "authorized_official_last_name": "TEWOGBADE",
        "authorized_official_first_name": "ADESEGUN",
        "authorized_official_middle_name": "OLUSHOLA",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST/OWNER",
        "authorized_official_telephone_number": "770-584-5267",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN013400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Dentistry of Lawrenceville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Yasmine Chester, MSW
• Edward Min CHI, D.O.
• Shailaja Chidella, M.D
• Huy Chiem, DPT
• Adamou Moumbagna Chigni, FNP
• Children's Medicine, P.C.
• Children's Therapy Group, Inc.
• Childrens Healthcare of Atlanta
• Sharon Childress, LPN
• Hiram P. Childs, PA-C

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2018; 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.