Smile 23 Georgia LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

SMILE 23 GEORGIA LLC

Doing business as

Buckhead Periodontics
Buckhead Specialty Group

Practice address

3280 Howell Mill Rd NW Ste 331
Atlanta, GA 30327-4109

Phone

(404) 261-9593

NPI assigned

Dec 6, 2021

Last updated

Dec 6, 2021By 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

Trevor Bryan Tune

Title

Cdo

Phone

(636) 233-1882

Specialties & licenses 1

Addresses

Other names 3

• Buckhead Periodontics Doing business as
• Buckhead Specialty Group Doing business as
• Buckhead Periodontics P.C. Former legal business name

Tax ID family

Buckhead Periodontics2 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.

• Smile 23 Georgia LLC

  • General Practice Dentistry
  • Atlanta, GA
  • NPI 1972263119
  NPD tax ID

Locations

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

{
    "created_epoch": "1638748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638748800000",
    "number": "1457019515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3280 HOWELL MILL RD NW STE 331",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303274109",
            "telephone_number": "404-261-9593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 HOWELL MILL RD NW STE 331",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303274109",
            "telephone_number": "404-261-9593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE 23 GEORGIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-06",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A",
        "authorized_official_last_name": "TUNE",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_middle_name": "BRYAN",
        "authorized_official_title_or_position": "CDO",
        "authorized_official_telephone_number": "636-233-1882"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Buckhead Periodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Buckhead Specialty Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Buckhead Periodontics P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Stephanie Larson Smeltzer, M.D.
• SMH Associates
• Joseph Carl Smiddy, MD
• Gloria V. Smikle, CPNP
• Zale Harlan Smilack, DDS
• Smile 23 Georgia LLC
• Smile 23 of Georgia PC
• Smile Envy PC
• Smile Forever LLC (Smile Forever Atlanta)
• Smile League P.C. (20/32 Family Dentistry)

• Periodontics in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Periodontics in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.