Canton Pediatric Dentistry PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN013057 Issued in GA

Legal business name

CANTON PEDIATRIC DENTISTRY PC

Practice address

3395 Sixes Rd
Suite 140
Canton, GA 30114

Phone

(678) 763-2600

Fax

(678) 893-0459

NPI assigned

Feb 11, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Vishant Nath, DMD

Title

Owner

Phone

(678) 763-2600

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234310400000",
    "number": "1437398666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3395 SIXES RD",
            "address_2": "SUITE 140",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "30114",
            "telephone_number": "678-763-2600",
            "fax_number": "678-893-0459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3395 SIXES RD",
            "address_2": "SUITE 140",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "30114",
            "telephone_number": "678-763-2600",
            "fax_number": "678-893-0459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANTON PEDIATRIC DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-11",
        "last_updated": "2009-02-11",
        "status": "A",
        "authorized_official_last_name": "NATH",
        "authorized_official_first_name": "VISHANT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-763-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN013057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "761564386",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Canton Marketplace Dentistry LLC
• Canton Northside Pharmacy Inc (Canton Northside Pharmacy)
• Canton Opco, LLC (The Landings of Canton Hills)
• Canton Orthodontics LLC
• Canton Orthopaedics and Sports Medicine, P.C.
• Canton Physical Medicare, LLC
• Canton Senior Living, LLC (Terrace at Riverstone)
• Canton Smiles Dentistry, PC (Canton Smiles Dentistry)
• Canton Specialty Imaging, LLC
• Canton Wellness Center LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2009; 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.