Pediatric Smile Studio

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN014232 Issued in GA

Legal business name

PEDIATRIC SMILE STUDIO

Practice address

2526 Shallowford Rd
Suite C
Marietta, GA 30066-3053

Phone

(678) 813-0500

Fax

(678) 813-0600

NPI assigned

May 21, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Eileen Buckle, DDS

Title

Dentist

Phone

(678) 982-5130

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369094400000",
    "number": "1619313384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2526 SHALLOWFORD RD",
            "address_2": "SUITE C",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300663053",
            "telephone_number": "678-813-0500",
            "fax_number": "678-813-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2526 SHALLOWFORD RD",
            "address_2": "SUITE C",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300663053",
            "telephone_number": "678-813-0500",
            "fax_number": "678-813-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC SMILE STUDIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-21",
        "last_updated": "2013-05-21",
        "status": "A",
        "authorized_official_last_name": "BUCKLE",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "678-982-5130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN014232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003108300",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arnanla Peay, RBT
• Stephanie Eve Peccia, PHARMD
• Mary Pate Pecunia, MS, EDS, LPC
• Pediatric and Adolescent Healthcare,PC
• Pediatric Associates, PC
• Pediatrics and Adolescent Medicine, PA
• Pediatrics at Whitlock P.C.
• Pediatrix Medical Group of Georgia, P.C.
• Tatiana Peduri
• Daniel Peeks, LAPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; 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.