Smoke Rise Dental

Primary specialty

DentistTaxonomy code 122300000X

License

DN 013813 Issued in GA

Legal business name

SMOKE RISE DENTAL

Practice address

5500 Lilburn Stone Mountain Rd Ste a
Stone Mountain, GA 30087-2873

Phone

(770) 923-5500

Fax

(770) 923-0044

NPI assigned

Mar 25, 2010

Organization subpart

No

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

Authorized official

Name

Hassan A. Abdel- Moeti

Title

Doctor

Phone

(770) 923-5500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269475200000",
    "number": "1548584154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 LILBURN STONE MOUNTAIN RD STE A",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300872873",
            "telephone_number": "770-923-5500",
            "fax_number": "770-923-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 LILBURN STONE MOUNTAIN RD STE A",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300872873",
            "telephone_number": "770-923-5500",
            "fax_number": "770-923-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMOKE RISE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-25",
        "last_updated": "2010-03-25",
        "status": "A",
        "authorized_official_last_name": "ABDEL- MOETI",
        "authorized_official_first_name": "HASSAN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "770-923-5500"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN 013813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Ashley Smith, LCSW
• Leiceta M Smith, PCA/HHA
• Lionel J Smith
• Roshonda A Smith
• Shantel Smith
• Smoke Rise Dental
• Smokerise Family Medical Assoc
• Elizabeth Imade Sobanjo, O.D
• Scott Sohn, RDN
• Omotunde Oyewunmi Solaru, B.PHARM

• Dentist in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2010; 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.