NPIMap

Organization Active NPI

Georgia Dental Professionals, PC

  • General Practice Dentistry
  • Gainesville, GA
National Provider Identifier
1609998483
Registry record updated Jul 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
011107 Issued in GA
Legal business name
GEORGIA DENTAL PROFESSIONALS, PC
Practice address
615 Green St NW
Suite 101
Gainesville, GA 30501-3378
Phone
(770) 532-2336
Fax
(770) 536-3905
NPI assigned
Apr 4, 2007
Last updated
Jul 24, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
GEORGIA DENTAL PROFESSIONALS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 24, 2019

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

Authorized official

Name
Leo Wheat
Title
Owner
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 011107 GA Primary

Addresses

Primary practice location

615 Green St NW
Suite 101
Gainesville, GA 30501-3378

Mailing address

615 Green St NW
Suite 101
Gainesville, GA 30501-3378
Phone (770) 532-2336

National Provider Directory

National Provider Directory
Tax ID family
Georgia Dental Professionals PC72 organizations share this tax ID, including this one
Part of
Georgia Dental Professionals PC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563926400000",
    "number": "1609998483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 GREEN ST NW",
            "address_2": "SUITE 101",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013378",
            "telephone_number": "770-532-2336",
            "fax_number": "770-536-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 GREEN ST NW",
            "address_2": "SUITE 101",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013378",
            "telephone_number": "770-532-2336",
            "fax_number": "770-536-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA DENTAL PROFESSIONALS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORGIA DENTAL PROFESSIONALS, PC",
        "enumeration_date": "2007-04-04",
        "last_updated": "2019-07-24",
        "status": "A",
        "authorized_official_last_name": "WHEAT",
        "authorized_official_first_name": "LEO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "011107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.