Providence Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PROVIDENCE DENTAL LLC

Doing business as

Inspire Dental Roswell

Practice address

225 N Macon St
Macon, GA 31210-6562

Phone

(478) 733-0857

NPI assigned

Jul 8, 2024

Last updated

Jul 8, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

PROVIDENCE DENTAL LLCAs reported in NPPES

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

Authorized official

Name

Heather Taylor

Title

Director

Phone

(478) 733-0857

Specialties & licenses 1

Addresses

Other names 1

• Inspire Dental Roswell Doing business as

Part of

Providence Dental LLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Providence Dental LLC

  • General Practice Dentistry
  • Macon, GA
  • NPI 1295189595
  NPPES parent name

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.

• Paul Jason Mann, D.M.D.

  • Dentist
  • Macon, GA
  • NPI 1447458856
  NPD
• John W. Hinds, DDS

  • General Practice Dentistry
  • Roswell, GA
  • NPI 1356483598
  NPD (past)

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

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1437995503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 SUN VALLEY DR STE C3",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765621",
            "telephone_number": "770-643-9499",
            "fax_number": "770-490-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 N MACON ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312106562",
            "telephone_number": "478-733-0857"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7000 Peachtree Dunwoody Rd Bldg 2",
            "address_purpose": "LOCATION",
            "city": "Sandy Springs",
            "state": "GA",
            "postal_code": "303281655",
            "country_code": "US",
            "telephone_number": "770-828-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 Sun Valley Dr Ste C3",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "300765621",
            "country_code": "US",
            "telephone_number": "770-643-9499",
            "fax_number": "770-490-9499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROVIDENCE DENTAL LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVIDENCE DENTAL LLC",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "478-733-0857"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Inspire Dental Roswell",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Clinic/Center in Macon, GA
• Providers in Macon, GA by specialty
• Dental Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.