NPIMap

Organization Active NPI

Children's Dentistry at Hamilton Mill

  • Pediatric Dentistry
  • Dacula, GA
National Provider Identifier
1437283025
Registry record updated Aug 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
GA12082 Issued in GA
Legal business name
CHILDREN'S DENTISTRY AT HAMILTON MILL
Practice address
2119 Hamilton Creek Pkwy
Suite 200
Dacula, GA 30019-3293
Phone
(678) 714-7011
Fax
(678) 714-8388
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2008

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

Authorized official

Name
Renee Caughey
Title
Financial Manager
Phone
(678) 714-7011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X GA12082 GA Primary

Addresses

Primary practice location

2119 Hamilton Creek Pkwy
Suite 200
Dacula, GA 30019-3293

Mailing address

2119 Hamilton Creek Pkwy
Suite 200
Dacula, GA 30019-3293
Phone (678) 714-7011

Other names 1

  • childrens dentistry at gainesville Other name

National Provider Directory

National Provider Directory
Tax ID family
Diane C Kelly DMD PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2119 Hamilton Creek Pkwy
Ste 200
Dacula, GA 30019
Phone (678) 714-7011

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218412800000",
    "number": "1437283025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2119 HAMILTON CREEK PKWY",
            "address_2": "SUITE 200",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300193293",
            "telephone_number": "678-714-7011",
            "fax_number": "678-714-8388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2119 HAMILTON CREEK PKWY",
            "address_2": "SUITE 200",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300193293",
            "telephone_number": "678-714-7011",
            "fax_number": "678-714-8388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S DENTISTRY AT HAMILTON MILL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2008-08-11",
        "status": "A",
        "authorized_official_last_name": "CAUGHEY",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "FINANCIAL MANAGER",
        "authorized_official_telephone_number": "678-714-7011"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "GA12082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "childrens dentistry at gainesville",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dacula, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2008; 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.