Organization Active NPI

Canton Endodontics,LLC

  • Endodontics
  • Canton, GA
National Provider Identifier
1477412906
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
CANTON ENDODONTICS,LLC
Practice address
170 River Green Ave Ste 102
Canton, GA 30114-4685
Phone
(943) 400-2911
Fax
(943) 400-2880
NPI assigned
Jan 20, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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

Authorized official

Name
Miss Iliana Moronta
Title
Office Lead
Phone
(943) 400-2911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

170 River Green Ave Ste 102
Canton, GA 30114-4685

Mailing address

170 River Green Ave Ste 102
Canton, GA 30114-4685
Phone (943) 400-2911

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1768867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768867200000",
    "number": "1477412906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 RIVER GREEN AVE STE 102",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301144685",
            "telephone_number": "943-400-2911",
            "fax_number": "943-400-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 RIVER GREEN AVE STE 102",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301144685",
            "telephone_number": "943-400-2911",
            "fax_number": "943-400-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANTON ENDODONTICS,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-20",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A",
        "authorized_official_last_name": "MORONTA",
        "authorized_official_first_name": "ILIANA",
        "authorized_official_title_or_position": "OFFICE LEAD",
        "authorized_official_telephone_number": "943-400-2911",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; 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.