NPIMap

Organization Active NPI

Center for Cosmetic and Sedation Dentistry

  • General Practice Dentistry
  • Lawrenceville, GA
National Provider Identifier
1487863429
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN010916 Issued in GA
Legal business name
CENTER FOR COSMETIC AND SEDATION DENTISTRY
Practice address
1030 Duluth Highway
Lawrenceville, GA 30043
Phone
(770) 995-1957
Fax
(770) 995-8579
NPI assigned
May 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

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

Authorized official

Name
Rachel Smallwood
Title
Office Manager
Phone
(770) 995-1957

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN010916 GA Primary

Addresses

Primary practice location

1030 Duluth Highway
Lawrenceville, GA 30043

Mailing address

1030 Duluth Highway
Lawrenceville, GA 30043
Phone (770) 995-1957

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664496000000",
    "number": "1487863429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 DULUTH HIGHWAY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30043",
            "telephone_number": "770-995-1957",
            "fax_number": "770-995-8579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 DULUTH HIGHWAY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30043",
            "telephone_number": "770-995-1957",
            "fax_number": "770-995-8579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR COSMETIC AND SEDATION DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A",
        "authorized_official_last_name": "SMALLWOOD",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-995-1957"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN010916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.