NPIMap

Organization Active NPI

Stockbridge Family Dental Group PC

  • General Practice Dentistry
  • Stockbridge, GA
National Provider Identifier
1366840159
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN013218 Issued in GA
Legal business name
STOCKBRIDGE FAMILY DENTAL GROUP PC
Practice address
3579 Highway 138 SE Ste 202
Stockbridge, GA 30281-6807
Phone
(770) 474-6111
Fax
(678) 762-0176
NPI assigned
Dec 11, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2014

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

Authorized official

Name
Dr. Ashish Pravin Vakharia, DMD
Title
Dentist/Owner
Phone
(412) 716-7907

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN013218 GA Primary

Addresses

Primary practice location

3579 Highway 138 SE Ste 202
Stockbridge, GA 30281-6807

Mailing address

3579 Highway 138 SE Ste 202
Stockbridge, GA 30281-6807
Phone (770) 474-6111

National Provider Directory

National Provider Directory
Tax ID family
Stockbridge Family Dental Group PC2 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.

Locations

3579 Highway 138 SE
Ste 202
Stockbridge, GA 30281
Phone (770) 474-6111

NPI Registry JSON

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

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418256000000",
    "number": "1366840159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3579 HIGHWAY 138 SE STE 202",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816807",
            "telephone_number": "770-474-6111",
            "fax_number": "678-762-0176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3579 HIGHWAY 138 SE STE 202",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816807",
            "telephone_number": "770-474-6111",
            "fax_number": "678-762-0176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOCKBRIDGE FAMILY DENTAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-11",
        "last_updated": "2014-12-11",
        "status": "A",
        "authorized_official_last_name": "VAKHARIA",
        "authorized_official_first_name": "ASHISH",
        "authorized_official_middle_name": "PRAVIN",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "412-716-7907",
        "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": "DN013218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; 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.