Active NPI
David J Cassidy, D.M.D.
- Pediatric Dentistry
- Dalton, GA
National Provider Identifier
1346334091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 9623
- Practice address
- 1403 Dug Gap Rd.
Dalton, GA 30720 - Phone
- (706) 226-8706
- Fax
- (706) 226-7649
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 9623 | GA | Primary |
Addresses
Primary practice location
1403 Dug Gap Rd.
Dalton, GA 30720
Mailing address
1403 Dug Gap Rd.
Dalton, GA 30720
Phone (706) 226-8706
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9182270 | Other | GA | DORAL DENTAL |
| 00288549A | Medicaid | GA | |
| 838614 | Other | GA | UNITED CONCORDIA |
| 0102702 | Other | GA | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9623 | GA | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David J Cassidy DMD, PC | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatric Dentistry
- Dalton, GA
- NPI 1326210139
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1346334091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1403 DUG GAP RD.",
"city": "DALTON",
"state": "GA",
"postal_code": "30720",
"telephone_number": "706-226-8706",
"fax_number": "706-226-7649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1403 DUG GAP RD.",
"city": "DALTON",
"state": "GA",
"postal_code": "30720",
"telephone_number": "706-226-8706",
"fax_number": "706-226-7649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASSIDY",
"first_name": "DAVID",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "GA",
"license": "9623",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DORAL DENTAL",
"identifier": "9182270",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00288549A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "838614",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0102702",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dalton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.