Jasmine Aliza Butler, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN122636 Issued in GA

Practice address

2880 Johnson Ferry Rd Ste 100
Marietta, GA 30062-8368

Phone

(678) 813-2388

NPI assigned

Mar 17, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Douglasville Dentistry for Kids

  • Pediatric Dentistry
  • Douglasville, GA
  • NPI 1881006427
  NPD (past)

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

{
    "created_epoch": "1615939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1326623661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 JOHNSON FERRY RD STE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300628368",
            "telephone_number": "678-813-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 JOHNSON FERRY RD STE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300628368",
            "telephone_number": "678-813-2388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3387 Highway 5",
            "address_purpose": "LOCATION",
            "city": "Douglasville",
            "state": "GA",
            "postal_code": "301356900",
            "country_code": "US",
            "telephone_number": "678-813-2388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "JASMINE",
        "middle_name": "ALIZA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-17",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN122636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalia Bustillo Hernandez, DC
• Busy Bees Concierge
• Busy Body Pediatric Therapy LLC
• John Douglas Butgereit
• Alyssa K Butler
• Marlow Butler, COTA
• Timberly Butler, MD
• Patricia Marie Butterworth
• Jennifer Butzen, LPC
• Madelyn Buxton, LPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.