Georgia Smile Team, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN009491 Issued in GA

Legal business name

GEORGIA SMILE TEAM, LLC

Practice address

578 S Enota Dr NE
Gainesville, GA 30501-8947

Phone

(770) 536-3254

NPI assigned

Oct 2, 2012

Last updated

Oct 2, 2012By 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

Mr. Eugene Witkin, DDS

Title

Owner

Phone

(770) 536-3254

Specialties & licenses 1

Addresses

Practitioners 2

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.

• Jashneek Kaur Cheema

  • Dentist
  • Gainesville, GA
  • NPI 1902649544
  NPD (past)
• Kasey Schock, DMD

  • General Practice Dentistry
  • Gainesville, GA
  • NPI 1083399711
  NPD (past)

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349136000000",
    "number": "1558612465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "578 S ENOTA DR NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305018947",
            "telephone_number": "770-536-3254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "578 S ENOTA DR NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305018947",
            "telephone_number": "770-536-3254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA SMILE TEAM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-02",
        "last_updated": "2012-10-02",
        "status": "A",
        "authorized_official_last_name": "WITKIN",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-536-3254",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN009491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Gainesville, GA
• Providers in Gainesville, 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 Oct 2, 2012; 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.