Peachtree Children's Dentistry Bethlehem

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN012519 Issued in GA

Legal business name

PEACHTREE CHILDREN'S DENTISTRY BETHLEHEM

Practice address

916 Loganville Hwy
Bethlehem, GA 30620-2144

Phone

(770) 867-5437

Fax

(770) 307-4115

NPI assigned

Jun 10, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Tamara M Cox

Title

Office Manager

Phone

(770) 979-6400

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370822400000",
    "number": "1447698717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 LOGANVILLE HWY",
            "city": "BETHLEHEM",
            "state": "GA",
            "postal_code": "306202144",
            "telephone_number": "770-867-5437",
            "fax_number": "770-307-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 LOGANVILLE HWY",
            "city": "BETHLEHEM",
            "state": "GA",
            "postal_code": "306202144",
            "telephone_number": "770-867-5437",
            "fax_number": "770-307-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE CHILDREN'S DENTISTRY BETHLEHEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-10",
        "last_updated": "2013-06-10",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-979-6400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN012519",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN012595",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Parrish
• Dhruvi Rashmikant Patel, DMD
• Sraddha Patel
• Elizabeth Diane Patton, RPH
• Pavilion Home Care LLC
• Lauren Peebles
• Polaris Spine & Neurosurgery Center PC
• Kevin Prashad, DMD
• Premier Podiatry, Inc
• Premise Health of Georgia Medical PC (Harrison Poultry Wellness Center)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2013; 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.