Thomasville Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN013177 Issued in GA

Legal business name

THOMASVILLE PEDIATRIC DENTISTRY

Practice address

215 Constitution Ave
Thomasville, GA 31757-4843

Phone

(229) 226-2386

Fax

(229) 226-9838

NPI assigned

Oct 21, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Marlin S Johnson, D.M.DNPI 1235244906

Title

Dentist/Owner

Phone

(229) 226-2386

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

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

• Marlin S Johnson, D.M.D.

  • Pediatric Dentistry
  • Thomasville, GA
  • NPI 1235244906
  NPD (past) Authorized official
• Lee Boney, DMD

  • Dentist
  • Thomasville, GA
  • NPI 1689836033
  NPD (past)
• Jodi Michelle Cox Davalos, D.M.D.

  • General Practice Dentistry
  • Thomasville, GA
  • NPI 1396107447

  Pediatric Dentistry

  NPD (past)

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224547200000",
    "number": "1518119718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 CONSTITUTION AVE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317574843",
            "telephone_number": "229-226-2386",
            "fax_number": "229-226-9838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 CONSTITUTION AVE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317574843",
            "telephone_number": "229-226-2386",
            "fax_number": "229-226-9838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMASVILLE PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2008-10-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MARLIN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "229-226-2386",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN013177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197090698C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomasville Obstetrics and Gynecology, P.C.
• Thomasville Operating Company LLC
• Thomasville Operations LLC
• Thomasville Orthodontics
• Thomasville Orthopedic Center, PC
• Thomasville Pharmacy Services Inc
• Thomasville Pharmacy Services Inc
• Thomasville Physical Therapy Inc
• Thomasville Primary Care
• Thomasville Surgery Center, Inc.

• Pediatric Dentistry in Thomasville, GA
• Providers in Thomasville, 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 21, 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.