Individual provider Active NPI

Shelandra Barnes, RDH

  • Dental Hygienist
  • Smyrna, GA
National Provider Identifier
1427687763
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH007469 Issued in GA
Practice address
3200 Highlands Pkwy SE Ste 110
Smyrna, GA 30082-5192
Phone
(679) 305-1090
NPI assigned
Apr 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DH007469 GA Primary

Addresses

Primary practice location

3200 Highlands Pkwy SE Ste 110
Smyrna, GA 30082-5192

Mailing address

905 Country Park Dr SE
Smyrna, GA 30080-8223

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address info@pediatricdentistryatvinings.com Direct
Direct Messaging Address info@pediatricdentistryatvinings.com
Direct Messaging Address info@pediatricdentistryatvinings.com Direct
Direct Messaging Address info@pediatricdentristryatvinings.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DH007469GAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Dentistry at Vinings CurrentSince Oct 27, 2024 Accepting new patients

Locations

3200 Highlands Pkwy SE
Ste 110
Smyrna, GA 30082
Phone (678) 305-1090

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1427687763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 COUNTRY PARK DR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300808223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 HIGHLANDS PKWY SE STE 110",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300825192",
            "telephone_number": "679-305-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNES",
        "first_name": "SHELANDRA",
        "name_prefix": "Ms.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-08",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "GA",
            "license": "DH007469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@pediatricdentistryatvinings.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3200 Highlands Pkwy SE Ste 110",
            "city": "Smyrna",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300825192",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@pediatricdentistryatvinings.com",
            "affiliation": "N",
            "address_1": "3200 Highlands Pkwy SE Ste 110",
            "city": "Smyrna",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300825192",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@pediatricdentistryatvinings.com",
            "affiliation": "N",
            "endpointDescription": "info@pediatricdentistryatvinings.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3200 Highlands Pkwy SE Ste 110",
            "city": "Smyrna",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300825192",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@pediatricdentristryatvinings.com",
            "affiliation": "N",
            "address_1": "3200 Highlands Pkwy SE Ste 110",
            "city": "Smyrna",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300825192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; 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.