NPIMap

Organization Active NPI

Coosa Dental Sleep Therapy LLC

  • Dentist
  • Cedartown, GA
National Provider Identifier
1336519636
Registry record updated Sep 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN010447 Issued in GA
Legal business name
COOSA DENTAL SLEEP THERAPY LLC
Practice address
109 East Ave
Cedartown, GA 30125-2921
Phone
(770) 748-7736
NPI assigned
Sep 29, 2015
Last updated
Sep 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2015

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

Authorized official

Name
Dr. David B Gandy, DDSNPI 1962571786
Title
Owner
Phone
(770) 748-7736

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN010447 GA Primary

Addresses

Primary practice location

109 East Ave
Cedartown, GA 30125-2921

Mailing address

109 East Ave
Cedartown, GA 30125-2921
Phone (770) 748-7736

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1443484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443484800000",
    "number": "1336519636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 EAST AVE",
            "city": "CEDARTOWN",
            "state": "GA",
            "postal_code": "301252921",
            "telephone_number": "770-748-7736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 EAST AVE",
            "city": "CEDARTOWN",
            "state": "GA",
            "postal_code": "301252921",
            "telephone_number": "770-748-7736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOSA DENTAL SLEEP THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-29",
        "last_updated": "2015-09-29",
        "status": "A",
        "authorized_official_last_name": "GANDY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-748-7736",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN010447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedartown, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2015; 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.