Ga SDS III PC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

GA SDS III PC

Practice address

91 W Wieuca Rd NE Ste 300
Atlanta, GA 30342-3248

Phone

(404) 303-7400

NPI assigned

Nov 1, 2023

Organization subpart

No

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

Authorized official

Name

Charlotte E Vial

Title

Direc of Cred and Prov Rel

Phone

(504) 638-0303

Specialties & licenses 2

Addresses

Tax ID family

Ga SDS III PC2 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.

• Ga SDS III PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Atlanta, GA
  • NPI 1861255093
  NPD tax ID

Locations

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.

• Ga SDS III PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Atlanta, GA
  • NPI 1861255093
  NPPES parent name

Practitioners 1

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

• Michael Harley Sebastian, DMD, MSD, PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Atlanta, GA
  • NPI 1891819652
  NPD (past)

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

{
    "created_epoch": "1698796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698796800000",
    "number": "1508639535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 CHURCH ST STE 1400",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372192214",
            "telephone_number": "504-638-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 W WIEUCA RD NE STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303423248",
            "telephone_number": "404-303-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GA SDS III PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-01",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A",
        "authorized_official_last_name": "VIAL",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIREC OF CRED AND PROV REL",
        "authorized_official_telephone_number": "504-638-0303"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ga Psychiatric Services, LLC
• Ga SDS III PC
• Ga Smile Center
• Ga Southern Dental LLC
• Ga Southern Dental LLC
• Ga Southern Dental LLC

• Orthodontics and Dentofacial Orthopedics Dentistry in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; 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.