Monroe Family and Cosmetic Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN012764 Issued in GA

Legal business name

MONROE FAMILY AND COSMETIC DENTISTRY

Practice address

2120 W Spring St
Suite 1100
Monroe, GA 30655-3197

Phone

(770) 266-7188

Fax

(770) 266-7178

NPI assigned

Dec 12, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jason Michael Campbell, DDS

Title

President

Phone

(770) 266-7188

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Olexa Podebryi, DDS

  • Dentist
  • Monroe, GA
  • NPI 1871808378

  General Practice

  NPD (past)

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

{
    "created_epoch": "1229040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229040000000",
    "number": "1518102961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 W SPRING ST",
            "address_2": "SUITE 1100",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306553197",
            "telephone_number": "770-266-7188",
            "fax_number": "770-266-7178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 W SPRING ST",
            "address_2": "SUITE 1100",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306553197",
            "telephone_number": "770-266-7188",
            "fax_number": "770-266-7178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONROE FAMILY AND COSMETIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-12",
        "last_updated": "2008-12-12",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-266-7188",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Grace Mitchell, MSW
• Dylan Keith Mixson, FNP-C
• Amar Mohan, MD
• Monroe Drug Company
• Monroe Family & Cosmetic Dentistry
• Monroe Hma Inc (Walton Regional Medical Center)
• Monroe Hma LLC (Walton Regional Nursing Home)
• Monroe Hma LLC (Clearview Regional Medical Center)
• Monroe Hma Physician Management LLC
• Monroe Hma, LLC (Clearview Regional Medical Center)

• General Practice Dentistry in Monroe, GA
• Providers in Monroe, 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 Dec 12, 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.