Aesthetic Restorative Dentistry, P. C.

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DN010888 Issued in GA

Legal business name

AESTHETIC RESTORATIVE DENTISTRY, P. C.

Practice address

5000 Shakerag HL
Peachtree City, GA 30269-3367

Phone

(770) 631-0044

Fax

(770) 631-9434

NPI assigned

Dec 22, 2016

Last updated

Dec 22, 2016By 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. W Taylor Dominy Jr., D.M.D

Title

Owner

Phone

(770) 631-0044

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Wilburn Taylor Dominy Jr., D.M.D

  • Prosthodontics
  • Peachtree City, GA
  • NPI 1225250822
  NPD (past)
• Ketan G Ginoya, DMD

  • General Practice Dentistry
  • Peachtree Cty, GA
  • NPI 1033497409
  NPD (past)

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

{
    "created_epoch": "1482364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482364800000",
    "number": "1437694791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 SHAKERAG HL",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302693367",
            "telephone_number": "770-631-0044",
            "fax_number": "770-631-9434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 SHAKERAG HL",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302693367",
            "telephone_number": "770-631-0044",
            "fax_number": "770-631-9434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AESTHETIC RESTORATIVE DENTISTRY, P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-22",
        "last_updated": "2016-12-22",
        "status": "A",
        "authorized_official_last_name": "DOMINY",
        "authorized_official_first_name": "W",
        "authorized_official_middle_name": "TAYLOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-631-0044",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "GA",
            "license": "DN010888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthodontics in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2016; 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.