Buckhead Cosmetic and Family Dentistry LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

DN013675 Issued in GA

Legal business name

BUCKHEAD COSMETIC AND FAMILY DENTISTRY LLC

Practice address

316 Pharr Rd NE
Atlanta, GA 30305-2304

Phone

(404) 400-0400

Fax

(404) 393-6929

NPI assigned

Dec 8, 2017

Organization subpart

No

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

Authorized official

Name

Bahareh Emadzadeh Nia, DMD

Title

Owner

Phone

(404) 400-0400

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1512691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512691200000",
    "number": "1407361702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 PHARR RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052304",
            "telephone_number": "404-400-0400",
            "fax_number": "404-393-6929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 PHARR RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052304",
            "telephone_number": "404-400-0400",
            "fax_number": "404-393-6929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKHEAD COSMETIC AND FAMILY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-08",
        "last_updated": "2017-12-08",
        "status": "A",
        "authorized_official_last_name": "NIA",
        "authorized_official_first_name": "BAHAREH",
        "authorized_official_middle_name": "EMADZADEH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-400-0400",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "DN013675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Buckhead Concierge Rehabilitation
• Buckhead Dental Associates, P.C.
• Buckhead Dental Center
• Buckhead Dermatology
• Buckhead Facial Plastic Surgery
• Buckhead Facial Plastic Surgery Center

• Clinic/Center in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2017; 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.