Organization Active NPI

Children'S Dentistry of West Cobb,LLC

  • Pediatric Dentistry
  • Kennesaw, GA
National Provider Identifier
1396472676
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
CHILDREN'S DENTISTRY OF WEST COBB,LLC
Practice address
5255 Stilesboro Rd NW Ste 110
Kennesaw, GA 30152-7739
Phone
(770) 499-2152
Fax
(770) 499-2157
NPI assigned
Aug 5, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Authorized official

Name
Christy D Chandler
Title
Office Manager
Phone
(770) 499-2152

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

5255 Stilesboro Rd NW Ste 110
Kennesaw, GA 30152-7739

Mailing address

5255 Stilesboro Rd NW Ste 110
Kennesaw, GA 30152-7739
Phone (770) 499-2152

National Provider Directory

National Provider Directory

Locations

5255 Stilesboro Rd NW
Ste 110
Kennesaw, GA 30152
Phone (770) 427-0504

Practitioners & affiliated clinicians

Practitioners 2

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": "1659657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659657600000",
    "number": "1396472676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5255 STILESBORO RD NW STE 110",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527739",
            "telephone_number": "770-499-2152",
            "fax_number": "770-499-2157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 STILESBORO RD NW STE 110",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527739",
            "telephone_number": "770-499-2152",
            "fax_number": "770-499-2157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S DENTISTRY OF WEST COBB,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-05",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A",
        "authorized_official_last_name": "CHANDLER",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-499-2152"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; 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.