Dentures and Family Dentistry

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

DN11497 Issued in GA

Legal business name

DENTURES AND FAMILY DENTISTRY

Doing business as

Smiles At Stone Mountain Festival

Practice address

1825 Rockbridge Rd
Suite 14 C
Stone Mountain, GA 30087-3335

Phone

(678) 672-2720

Fax

(678) 672-2722

NPI assigned

Oct 27, 2009

Last updated

Jul 30, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jimmie Lee Blount, DDS

Title

Owner/ Doctor

Phone

(770) 482-7800

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Smiles At Stone Mountain Festival Doing business as

Tax ID family

Dentures and Family Dentistry2 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.

• Dentures and Family Dentistry

  • General Practice Dentistry
  • Covington, GA
  • NPI 1215482765
  NPD tax ID

Locations

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

{
    "created_epoch": "1256601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280448000000",
    "number": "1396071270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 ROCKBRIDGE RD",
            "address_2": "SUITE 14 C",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873335",
            "telephone_number": "770-482-7800",
            "fax_number": "770-482-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 ROCKBRIDGE RD",
            "address_2": "SUITE 14 C",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873335",
            "telephone_number": "678-672-2720",
            "fax_number": "678-672-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTURES AND FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-27",
        "last_updated": "2010-07-30",
        "status": "A",
        "authorized_official_last_name": "BLOUNT",
        "authorized_official_first_name": "JIMMIE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER/ DOCTOR",
        "authorized_official_telephone_number": "770-482-7800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "GA",
            "license": "DN11497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000749504A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smiles At Stone Mountain Festival",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dekalbcommunityserviceboard
• Linda G Dennard, LCSW
• Mira Desai, AGPCNP
• Rohit Manubhai Desai, MD
• Tejal Haresh Desai, AA
• Madison Rachelle Desch
• Developmental & Rehabilitative Service, Inc

• Health Maintenance Organization in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Health Maintenance Organization in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2010; 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.