NPIMap

Organization Active NPI

Marietta Public Health Center

Doing business as Cobb County Board of Health

  • Public Health Dentistry
  • Marietta, GA
National Provider Identifier
1598819690
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
DN011004 Issued in GA
Legal business name
MARIETTA PUBLIC HEALTH CENTER
Doing business as
Cobb County Board of Health
Practice address
1650 County Services Pkwy SW
Marietta, GA 30008-4010
Phone
(770) 514-2361
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Tyler Carlson
Title
Administration Director
Phone
(770) 514-2342

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223D0001X DN011004 GA Primary

Addresses

Primary practice location

1650 County Services Pkwy SW
Marietta, GA 30008-4010

Mailing address

1650 County Services Pkwy SW
Marietta, GA 30008-4010
Phone (770) 514-2361

Other names 1

  • Cobb County Board of Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lithia Springs HLTH CNT3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598819690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COUNTY SERVICES PKWY SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300084010",
            "telephone_number": "770-514-2361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COUNTY SERVICES PKWY SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300084010",
            "telephone_number": "770-514-2361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIETTA PUBLIC HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "ADMINISTRATION DIRECTOR",
        "authorized_official_telephone_number": "770-514-2342",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": "GA",
            "license": "DN011004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cobb County Board of Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.