Ponce Dental Studio Buckhead, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PONCE DENTAL STUDIO BUCKHEAD, LLC

Practice address

3189 Maple Dr NE
Atlanta, GA 30305-2501

Phone

(404) 383-1111

NPI assigned

Jun 11, 2025

Last updated

Jun 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amanda Crawford

Title

Administrative Support

Phone

(321) 750-9537

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessica Didato, D.D.S.

  • Dentist
  • Atlanta, GA
  • NPI 1750733085
  NPD (past)

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

{
    "created_epoch": "1749600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749600000000",
    "number": "1326933029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3189 MAPLE DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052501",
            "telephone_number": "404-383-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3189 MAPLE DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052501",
            "telephone_number": "404-383-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONCE DENTAL STUDIO BUCKHEAD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-11",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "ADMINISTRATIVE SUPPORT",
        "authorized_official_telephone_number": "321-750-9537"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Pomerleau, M.D.
• Aisha Pompey
• Mario Carlos Ponce Alvarez, M.D.
• Ponce de Leon Surgery Center, LLC
• Ponce Dental Group, PC
• Ponce Dental Studio LLC
• Ponce Infectious Disease Center Pharmacy
• Angelina Ponce
• Chelsea E Ponder, MSN, RN, ACNP
• Erinn Nicole Ponder, D.P.M.

• General Practice Dentistry in Atlanta, GA
• Providers in Atlanta, 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 11, 2025; 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.