Peach Dental Associates LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN013552 Issued in GA

Legal business name

PEACH DENTAL ASSOCIATES LLC

Practice address

78 Dawson Village Way N Ste 170
Dawsonville, GA 30534-5643

Phone

(407) 340-4304

NPI assigned

Jan 18, 2018

Organization subpart

No

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

Authorized official

Name

Desiree Thompson

Title

Front Office

Phone

(770) 535-8900

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516233600000",
    "number": "1497263909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 THOMPSON BRIDGE RD",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305011774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 DAWSON VILLAGE WAY N STE 170",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305345643",
            "telephone_number": "407-340-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH DENTAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-18",
        "last_updated": "2018-01-18",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "DESIREE",
        "authorized_official_title_or_position": "FRONT OFFICE",
        "authorized_official_telephone_number": "770-535-8900"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ortho Sport and Spine Physicians Dawsonville
• Madison Amelia Orton, DPT
• Jennifer Owen, DPT
• Woong Jun Park, DMD
• Jaina T Patel, FNP-BC
• Peachtree Orthopaedic Clinic, PA
• Lindsay Nicole Petrangeli, RN
• George Joseph Petro Jr., M.D.
• Megan Phelan, LCSW
• Megan Phillips, PT, DPT

• General Practice Dentistry in Dawsonville, GA
• Providers in Dawsonville, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.