Covenant Childrens Dental Care Center

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN011370 Issued in GA

Legal business name

COVENANT CHILDRENS DENTAL CARE CENTER

Practice address

7446 Covington Hwy
Lithonia, GA 30058-7612

Phone

(770) 323-1280

Fax

(770) 323-8622

NPI assigned

Nov 11, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Carolyn W. Williams, D.D.S.

Title

Ceo

Phone

(770) 323-1280

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1226361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235520000000",
    "number": "1376797829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7446 COVINGTON HWY",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300587612",
            "telephone_number": "770-323-1280",
            "fax_number": "770-323-8622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7446 COVINGTON HWY",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300587612",
            "telephone_number": "770-323-1280",
            "fax_number": "770-323-8622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT CHILDRENS DENTAL CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-11",
        "last_updated": "2009-02-25",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-323-1280",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN011370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Lithonia, GA
• Providers in Lithonia, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2009; 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.