NPIMap

Organization Active NPI

Covington Dental Care

  • General Practice Dentistry
  • Covington, GA
National Provider Identifier
1356834360
Registry record updated Jun 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN012610 Issued in GA
Legal business name
COVINGTON DENTAL CARE
Practice address
4139 Baker Street
Suite 15
Covington, GA 30014
Phone
(770) 787-1013
Fax
(770) 787-1018
NPI assigned
Jun 13, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2018

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

Authorized official

Name
Dr. Anitha R Reddy, DMDNPI 1578681102
Title
Ceo/Dentist
Phone
(770) 787-1013

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN012610 GA Primary

Addresses

Primary practice location

4139 Baker Street
Suite 15
Covington, GA 30014

Mailing address

4139 Baker Street,
Suite 15
Covington, GA 30014
Phone (770) 787-1013

Other identifiers 1

IdentifierTypeStateIssuer
000952465ABCDMedicaidGA

Other names 1

  • East Metro Beautiful Smiles Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Covington Dental Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the 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.

NPI Registry JSON

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528848000000",
    "number": "1356834360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4139 BAKER STREET,",
            "address_2": "SUITE 15",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "30014",
            "telephone_number": "770-787-1013",
            "fax_number": "770-787-1018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4139 BAKER STREET",
            "address_2": "SUITE 15",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "30014",
            "telephone_number": "770-787-1013",
            "fax_number": "770-787-1018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVINGTON DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-13",
        "last_updated": "2018-06-13",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "ANITHA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO/DENTIST",
        "authorized_official_telephone_number": "770-787-1013",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000952465ABCD",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Metro Beautiful Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Covington, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2018; 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.