Pdaa 2 Evans LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

PDAA 2 EVANS LLC

Doing business as

Augusta Children's Dental Center West

Practice address

4250 Washington Rd Ste 1
Evans, GA 30809-3351

Phone

(706) 524-7628

NPI assigned

Dec 12, 2024

Last updated

Dec 31, 2024By 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. Akindeko ObebeNPI 1811124969

Title

Dentist

Phone

(216) 849-8097

Specialties & licenses 1

Addresses

Other names 1

• Augusta Children's Dental Center West Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Akindeko D Obebe, D.M.D

  • Pediatric Dentistry
  • Augusta, GA
  • NPI 1811124969
  NPD Authorized official

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

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735603200000",
    "number": "1417764507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 WASHINGTON RD STE 1",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093351",
            "telephone_number": "706-524-7628",
            "fax_number": "706-343-3995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 WASHINGTON RD STE 1",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093351",
            "telephone_number": "706-524-7628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PDAA 2 EVANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-12",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A",
        "authorized_official_last_name": "OBEBE",
        "authorized_official_first_name": "AKINDEKO",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "216-849-8097",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Augusta Children's Dental Center West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Aubrie Michelle Patrick, NP-C
• Peace and Comfort Home Health Care LLC
• Lamar B Peacock, MD
• Jason Leonard Pearce, LCSW
• Elizabeth Peavy, M.ED.CCC-SLP
• Jennifer R. Pedersen, DO

• Pediatric Dentistry in Evans, GA
• Providers in Evans, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; 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.