Children's Dentistry of West Georgia, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

CHILDREN'S DENTISTRY OF WEST GEORGIA, LLC

Practice address

202 Calumet Center Rd
Lagrange, GA 30241-6712

Phone

(706) 298-5007

NPI assigned

Aug 27, 2026

Last updated

Aug 27, 2026By 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

Angela Denise Bulloch-Patterson, DMDNPI 1053444547

Title

Owner

Phone

(706) 298-5007

Specialties & licenses 1

Addresses

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.

• Angela Bulloch-Patterson, DMD

  • Pediatric Dentistry
  • Lagrange, GA
  • NPI 1053444547
  NPD (past) Authorized official

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

{
    "created_epoch": "1787788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787788800000",
    "number": "1437066982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 CALUMET CENTER RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302416712",
            "telephone_number": "706-298-5007",
            "fax_number": "706-298-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 CALUMET CENTER RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302416712",
            "telephone_number": "706-298-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S DENTISTRY OF WEST GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-27",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A",
        "authorized_official_last_name": "BULLOCH-PATTERSON",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-298-5007",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chattahoochee Valley Imaging, PC
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• Jordan Lyndsey Child, LMFT
• Children and Teen Dental Group (American Dental of LaGrange)
• Childrens Clinic of Lagrange, LLC
• Drake Childress, DMD
• George W Childress, D.M.D.
• Chiropractic Soulution, LLC
• Clark-Holder Clinic, P.a.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; 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.