MC Dental LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

MC DENTAL LLC

Practice address

448 West Belmont Drive
Calhoun, GA 30701-3016

Phone

(762) 204-6433

Fax

(706) 629-8126

NPI assigned

Oct 11, 2019

Organization subpart

No

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

Authorized official

Name

Theresa Chung

Title

Principal- Walmart Health Dental

Phone

(762) 204-6433

Specialties & licenses 1

Addresses

Tax ID family

MC Dental LLC2 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.

• MC Dental LLC

  • Dentist
  • Dallas, GA
  • NPI 1174181119
  NPD tax ID

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638835200000",
    "number": "1447892377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW 8TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727160445",
            "telephone_number": "479-204-1258",
            "fax_number": "479-277-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "448 WEST BELMONT DRIVE",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307013016",
            "telephone_number": "762-204-6433",
            "fax_number": "706-629-8126"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Market Place Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Cartersville",
            "state": "GA",
            "postal_code": "301212236",
            "country_code": "US",
            "telephone_number": "770-607-5167",
            "fax_number": "770-607-5120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1025 Bullsboro Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302656800",
            "country_code": "US",
            "telephone_number": "770-502-2262",
            "fax_number": "770-502-2287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MC DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-11",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "PRINCIPAL- WALMART HEALTH DENTAL",
        "authorized_official_telephone_number": "762-204-6433"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Makamie G Maton
• Max D Proctor Chiropractic Clinic PC
• May Behavioral Services, LLC
• Lara M May
• Catherine Harris Mayberry, D.C.
• MC DO Optometry LLC
• MC Medical LLC
• Anne McAfee
• Kenneth John McAfee, DMD
• Meridee Jane McArthur, PMHNP

• Dentist in Calhoun, GA
• Providers in Calhoun, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.