Allred Dental Group LLC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

014067 Issued in GA

Legal business name

ALLRED DENTAL GROUP LLC

Doing business as

Allred Family Dentistry

Practice address

743 S 8TH St
Griffin, GA 30224-4818

Phone

(770) 228-6101

Fax

(770) 228-6170

NPI assigned

Feb 1, 2007

Last updated

Sep 16, 2016By 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

Shelli Anne Carroll

Title

Office Manager

Phone

(706) 741-8433

Specialties & licenses 4

Addresses

Other identifiers 4

Other names 1

• Allred Family Dentistry Doing business as

Tax ID family

Allred Dental Group LLC2 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.

• Allred Family Dentistry

  • Dental Clinic/Center
  • Griffin, GA
  • NPI 1003296633
  NPD tax ID

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473984000000",
    "number": "1396882783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 S 8TH ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244818",
            "telephone_number": "770-228-6101",
            "fax_number": "770-228-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 S 8TH ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244818",
            "telephone_number": "770-228-6101",
            "fax_number": "770-228-6170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLRED DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2016-09-16",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "SHELLI",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "706-741-8433"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "GA",
            "license": "010469",
            "primary": false
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "GA",
            "license": "014067",
            "primary": true
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "GA",
            "license": "014094",
            "primary": false
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "GA",
            "license": "014960",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00727097A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "877225484A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340647560A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003162738C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allred Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Toluwalase Emmanuel Akinfisoye, MD
• Ayman Salah Al-Hakim, MD
• Deanna Albritton, CNA
• Gary Alexander, N.P.
• Lenora Allen, M.D.
• Allred Dentistry Griffin (Allred Dentistry)
• Allred Family Dentistry
• Marc Brandon Allred, DMD
• Robert Benjamin Allred, DMD, M.S.
• Fabian Andres Altamirano Donoso, M.D.

• Health Maintenance Organization in Griffin, GA
• Providers in Griffin, 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 Sep 16, 2016; 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.