NPIMap

Organization Active NPI

Edgewood Smiles Dentistry, PC

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1588210207
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
EDGEWOOD SMILES DENTISTRY, PC
Practice address
144 Moreland Ave NE Ste a
Atlanta, GA 30307-2660
Phone
(404) 329-0411
NPI assigned
Aug 19, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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

Authorized official

Name
Katie McCann Lee
Title
Owner
Phone
(714) 845-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

144 Moreland Ave NE Ste a
Atlanta, GA 30307-2660

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8500

National Provider Directory

National Provider Directory

Locations

144 Moreland Ave NE
Ste A
Atlanta, GA 30307
Phone (404) 329-0411

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566172800000",
    "number": "1588210207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 MORELAND AVE NE STE A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303072660",
            "telephone_number": "404-329-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD SMILES DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-19",
        "last_updated": "2019-08-19",
        "status": "A",
        "authorized_official_last_name": "MCCANN LEE",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-845-8500"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; 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.