Atlanta Dental Center, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10515 Issued in GA

Legal business name

ATLANTA DENTAL CENTER, LLC

Doing business as

Atlanta Dental Center

Practice address

620 Peachtree St NE Ste 204
Atlanta, GA 30308-2355

Phone

(404) 872-7755

Fax

(877) 583-7599

NPI assigned

Nov 19, 2014

Last updated

Nov 19, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Debra Jean Benk

Title

President

Phone

(404) 872-7755

Specialties & licenses 5

Addresses

Other identifiers 5

Other names 1

• Atlanta Dental Center Doing business as

Tax ID family

Atlanta Dental Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Atlanta Dental Center, LLC

  • General Practice Dentistry
  • Atlanta, GA
  • NPI 1609300516
  NPD tax ID

Practitioners 1

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.

• Robert Vincent Schmidt, DDS

  • Dentist
  • Atlanta, GA
  • NPI 1699868281
  NPD (past)

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

{
    "created_epoch": "1416355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416355200000",
    "number": "1619374659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 PEACHTREE ST NE STE 204",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082355",
            "telephone_number": "404-872-7755",
            "fax_number": "877-583-7599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 PEACHTREE ST NE STE 204",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082355",
            "telephone_number": "404-872-7755",
            "fax_number": "877-583-7599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA DENTAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-19",
        "last_updated": "2014-11-19",
        "status": "A",
        "authorized_official_last_name": "BENK",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-872-7755",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN014823",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "0121147",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN014327",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "10515",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "014152",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. ROBERT SCHMIDT",
            "identifier": "1699868281",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. ROBERT VAZQUEZ",
            "identifier": "1992890107",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. MARIA PAPPAS",
            "identifier": "1750438685",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. BRITTANY CORBETT",
            "identifier": "1568878684",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. JESSICA LEE",
            "identifier": "1043528193",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atlanta Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Atlanta, GA
• Providers in Atlanta, 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 Nov 19, 2014; 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.