Tina Michell Champion, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DN015080 Issued in GA

Practice address

1980M N Columbia St
Milledgeville, GA 31061-2020

Phone

(478) 387-7015

NPI assigned

Jul 2, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Tina Michell Champion-Harris Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nou You, LLC

  • General Practice Dentistry
  • Decatur, GA
  • NPI 1811729346
  NPD Authorized official

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1407019243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1547 BELL FLOWER CT",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300883707",
            "telephone_number": "708-218-3296",
            "fax_number": "708-575-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1980M N COLUMBIA ST",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310612020",
            "telephone_number": "478-387-7015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "424 Decatur St SE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303121848",
            "country_code": "US",
            "telephone_number": "708-218-3296",
            "fax_number": "708-575-0401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAMPION",
        "first_name": "TINA",
        "middle_name": "MICHELL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025754",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015080",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN015080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Home",
            "affiliation": "N",
            "address_1": "1547 Bell Flower Ct",
            "city": "Stone Mountain",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300883707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "CHAMPION-HARRIS",
            "middle_name": "MICHELL",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dentist in Milledgeville, GA
• Providers in Milledgeville, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.