Familia Dentistry of Georgia, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

FAMILIA DENTISTRY OF GEORGIA, LLC

Practice address

4574 Lawrenceville Hwy NW Ste 120
Lilburn, GA 30047-3605

Phone

(678) 370-0591

NPI assigned

Jul 13, 2020

Last updated

Jan 20, 2023By 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. David Allen

Title

Chief Clinical Officer

Phone

(678) 370-0591

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674172800000",
    "number": "1407474794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16539",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314163239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4574 LAWRENCEVILLE HWY NW STE 120",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473605",
            "telephone_number": "678-370-0591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILIA DENTISTRY OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-13",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "678-370-0591",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Lilburn, GA
• Providers in Lilburn, GA by specialty
• Dental Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.