NPIMap

Organization Active NPI

Little P.C.

  • Dental Clinic/Center
  • Marietta, GA
National Provider Identifier
1376053710
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
LITTLE P.C.
Practice address
2100 Roswell Rd Ste 1108
Marietta, GA 30062-0883
Phone
(678) 401-5089
Fax
(864) 670-5285
NPI assigned
Oct 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

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

Authorized official

Name
Monique Tucker
Title
Director of Insurance
Phone
(843) 990-9998

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

2100 Roswell Rd Ste 1108
Marietta, GA 30062-0883

Mailing address

4921 Centre Pointe Dr Ste 201
North Charleston, SC 29418-6997
Phone (843) 990-9998

Other names 1

  • East Lake Dental Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Little PC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2100 Roswell Rd
Ste 1108
Marietta, GA 30062
Phone (678) 401-5089

NPI Registry JSON

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

{
    "created_epoch": "1507680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512691200000",
    "number": "1376053710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4921 CENTRE POINTE DR STE 201",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294186997",
            "telephone_number": "843-990-9998",
            "fax_number": "864-670-5285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 ROSWELL RD STE 1108",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300620883",
            "telephone_number": "678-401-5089",
            "fax_number": "864-670-5285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-11",
        "last_updated": "2017-12-08",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "MONIQUE",
        "authorized_official_title_or_position": "DIRECTOR OF INSURANCE",
        "authorized_official_telephone_number": "843-990-9998"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Lake Dental Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2017; 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.