Classic City Orthodontics, LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

CLASSIC CITY ORTHODONTICS, LLC

Practice address

1020 Jamestown Blvd BLDG 100
Watkinsville, GA 30677-4131

Phone

(706) 549-4748

Fax

(706) 549-9822

NPI assigned

Dec 4, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Christopher Tradd Harter, DMD

Title

President

Phone

(706) 549-4748

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alex M Culberson, DMD, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Athens, GA
  • NPI 1073050423
  NPD
• C. Tradd Harter, D.M.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Athens, GA
  • NPI 1669591947
  NPD (past)

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

{
    "created_epoch": "1575417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575417600000",
    "number": "1316584758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 JAMESTOWN BLVD BLDG 100",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306774131",
            "telephone_number": "706-549-4748",
            "fax_number": "706-549-9822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 JAMESTOWN BLVD BLDG 100",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306774131",
            "telephone_number": "706-549-4748",
            "fax_number": "706-549-9822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Oglethorpe Ave Ste 3",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306062263",
            "country_code": "US",
            "telephone_number": "706-549-4748",
            "fax_number": "706-549-9822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CLASSIC CITY ORTHODONTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-04",
        "last_updated": "2019-12-04",
        "status": "A",
        "authorized_official_last_name": "HARTER",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "TRADD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-549-4748",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clarity Counseling, LLC
• Amie Melissa Clark, CRNA
• Brooklyn S Clark
• Sylvia Anne Clark
• Classic City Chiropractic, PC
• Robert Dean Clower, M.D.
• Marcella Cochran
• Spencer Coker, RBT
• Joseph Nicholas Colasurdo, DPM
• Mary Elizabeth Cole, B.A, LMSW

• Orthodontics and Dentofacial Orthopedics Dentistry in Watkinsville, GA
• Providers in Watkinsville, GA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; 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.