Cobb Family Dentistry, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN012338 Issued in GA

Legal business name

COBB FAMILY DENTISTRY, LLC

Practice address

5345 Floyd Rd SW Ste M
Mableton, GA 30126-2270

Phone

(770) 944-8620

NPI assigned

Oct 8, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Logan V Gordon

Title

Business Manager

Phone

(770) 944-8620

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.

• Phillip Wayne Bracken, DDS

  • General Practice Dentistry
  • Mableton, GA
  • NPI 1477651198
  NPD (past)

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

{
    "created_epoch": "1254960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254960000000",
    "number": "1598090508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5345 FLOYD RD SW STE M",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301262270",
            "telephone_number": "770-944-8620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5345 FLOYD RD SW STE M",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301262270",
            "telephone_number": "770-944-8620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COBB FAMILY DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-08",
        "last_updated": "2009-10-08",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "LOGAN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "770-944-8620",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keshawna Chatmon, LCSW
• Chiron Therapy Services LLC (Acti-Kare In Home Responsive Care/Cobb)
• Andrew B. Chung, M.D., PH.D.
• City Medical Supply Inc.
• Clinical Intervention Specialists
• Lawrence Cohen
• Kara Beckett Coleman, LCSW
• Marchell Coleman
• Community Dental Services Inc
• Compassionate Companions Healthcare Services

• General Practice Dentistry in Mableton, GA
• Providers in Mableton, 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 8, 2009; 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.