Roswell Pediatric Dentistry PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN013057 Issued in GA

Legal business name

ROSWELL PEDIATRIC DENTISTRY PC

Practice address

10930 Crabapple Rd Ste 106
Roswell, GA 30075-5825

Phone

(678) 763-2600

Fax

(678) 893-0459

NPI assigned

Apr 22, 2008

Last updated

Apr 22, 2008By 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

Dr. Vishant Nath, DMD

Title

Owner/Dentist

Phone

(678) 763-2600

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1568636405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10930 CRABAPPLE RD STE 106",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300755825",
            "telephone_number": "678-763-2600",
            "fax_number": "678-893-0459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10930 CRABAPPLE RD STE 106",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300755825",
            "telephone_number": "678-763-2600",
            "fax_number": "678-893-0459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSWELL PEDIATRIC DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "NATH",
        "authorized_official_first_name": "VISHANT",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "678-763-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN013057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "761564386",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Roswell, GA
• Providers in Roswell, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.