NPIMap

Organization Active NPI

Specialty Providers at Children's, LLC

  • Pediatric Dentistry
  • Brookhaven, GA
National Provider Identifier
1346606076
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
SPECIALTY PROVIDERS AT CHILDREN'S, LLC
Practice address
1575 Northeast Expy NE
Brookhaven, GA 30329-2401
Phone
(404) 785-7876
NPI assigned
Jan 11, 2016
Last updated
Oct 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Authorized official

Name
Joe Cavasin
Title
Manager Provider Enrollment
Phone
(404) 785-5869

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X NU Primary

Addresses

Primary practice location

1575 Northeast Expy NE
Brookhaven, GA 30329-2401

Mailing address

1575 Northeast Expy NE
Brookhaven, GA 30329-2401

National Provider Directory

National Provider Directory

Locations

1405 Clifton Rd NE
Fl 4
Atlanta, GA 30322
Phone (404) 785-2311

5461 Meridian Mark Rd
Ste 400
Sandy Springs, GA 30342
Phone (404) 785-1112

Practitioners & affiliated clinicians

Practitioners 42

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.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1452470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760659200000",
    "number": "1346606076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 NORTHEAST EXPY NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303292401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 NORTHEAST EXPY NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303292401",
            "telephone_number": "404-785-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY PROVIDERS AT CHILDREN'S, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-11",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A",
        "authorized_official_last_name": "CAVASIN",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "MANAGER PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "404-785-5869"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.