Villa Rica Dental Smiles LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

VILLA RICA DENTAL SMILES LLC

Practice address

600 Carrollton Villa Rica Hwy Ste 614
Villa Rica, GA 30180-4969

Phone

(678) 785-4644

NPI assigned

Jun 13, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Praveen R Gudipati, DMD

Title

Owner

Phone

(404) 966-7766

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1718236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718236800000",
    "number": "1316780968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 AZALEA BLUFF DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300413207",
            "telephone_number": "404-966-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CARROLLTON VILLA RICA HWY STE 614",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301804969",
            "telephone_number": "678-785-4644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLA RICA DENTAL SMILES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-13",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A",
        "authorized_official_last_name": "GUDIPATI",
        "authorized_official_first_name": "PRAVEEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-966-7766",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• El Janeo D Vereen
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• Villa Rica Behavioral Health PC
• Villa Rica Family Dental
• Villa Rica OB GYN Inc
• Villa Rica RX LLC
• Villa Rica RX LLC
• Richard Brent Wadsworth Jr., LAPC

• General Practice Dentistry in Villa Rica, GA
• Providers in Villa Rica, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.