Kidz Tooth Zone, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

KIDZ TOOTH ZONE, LLC

Practice address

907 Pavilion CT
McDonough, GA 30253-6665

Phone

(678) 272-6195

Fax

(678) 759-1926

NPI assigned

Oct 31, 2018

Organization subpart

No

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

Authorized official

Name

Carolyn Wilmer Williams, D.D.S.

Title

Managing Member

Phone

(404) 960-8208

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540944000000",
    "number": "1497222053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 PAVILION CT",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302536665",
            "telephone_number": "678-272-6195",
            "fax_number": "678-759-1926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 PAVILION CT",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302536665",
            "telephone_number": "678-272-6195",
            "fax_number": "678-759-1926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDZ TOOTH ZONE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-31",
        "last_updated": "2018-10-31",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "WILMER",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "404-960-8208",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in McDonough, GA
• Providers in McDonough, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; 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.