NPIMap

Organization Active NPI

Your Smile Family Dentistry

  • Dentist
  • Snellville, GA
National Provider Identifier
1477723385
Registry record updated Sep 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
YOUR SMILE FAMILY DENTISTRY
Practice address
3931 Highway 78 W
Suite a
Snellville, GA 30039-3930
Phone
(770) 985-1050
NPI assigned
Mar 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2008

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

Authorized official

Name
Heather Allen, DENTIST
Title
Doctor
Phone
(404) 294-3600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

3931 Highway 78 W
Suite a
Snellville, GA 30039-3930

Mailing address

PO Box 33222
Decatur, GA 30033-0222
Phone (770) 985-1050

Other identifiers 1

IdentifierTypeStateIssuer
00581215AMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Your Smile Family Dentistry2 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.

NPI Registry JSON

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1477723385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33222",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300330222",
            "telephone_number": "770-985-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3931 HIGHWAY 78 W",
            "address_2": "SUITE A",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300393930",
            "telephone_number": "770-985-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR SMILE FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-06",
        "last_updated": "2008-09-17",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "404-294-3600",
        "authorized_official_credential": "DENTIST"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00581215A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; 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.