Stockbridge Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

STOCKBRIDGE DENTAL GROUP

Practice address

330 Corporate Center CT
Suite a
Stockbridge, GA 30281-6360

Phone

(678) 289-6707

NPI assigned

Feb 5, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wendy Flanagan

Title

District Manager

Phone

(678) 289-6707

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, and the practitioner matching its NPPES authorized official.

• Sora Kim

  • General Practice Dentistry
  • Stockbridge, GA
  • NPI 1164622635
  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528107943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 CORPORATE CENTER CT",
            "address_2": "SUITE A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816360",
            "telephone_number": "678-289-6707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 CORPORATE CENTER CT",
            "address_2": "SUITE A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816360",
            "telephone_number": "678-289-6707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOCKBRIDGE DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FLANAGAN",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "DISTRICT MANAGER",
        "authorized_official_telephone_number": "678-289-6707"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen B Stevenson, M.D.
• Derex L Stewart, MD
• Jamari Stewart
• Susan Ann Stewart, LPC
• Briana Stith, PA-C
• Stockbridge Dental LLC
• Stockbridge Dental Smiles 2 LLC (Cumming Dental Smiles)
• Stockbridge Dental Smiles LLC (Stockbridge Dental Smiles)
• Stockbridge Dialysis Clinic, LLC
• Stockbridge Family Care Center

• General Practice Dentistry in Stockbridge, GA
• Providers in Stockbridge, 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 Aug 22, 2020; 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.