NPIMap

Organization Active NPI

Georgia Dental Associates, LLC

Doing business as Georgia Dental Associates of Tifton

  • Dental Clinic/Center
  • Tifton, GA
National Provider Identifier
1619516002
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
GEORGIA DENTAL ASSOCIATES, LLC
Doing business as
Georgia Dental Associates of Tifton
Practice address
315 14TH St E
Tifton, GA 31794-4018
Phone
(229) 313-5083
NPI assigned
Jan 2, 2020
Last updated
Jan 25, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
GEORGIA DENTAL ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Authorized official

Name
Nettie S Hatcher
Title
Director of Operations
Phone
(229) 848-2685

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

315 14TH St E
Tifton, GA 31794-4018

Mailing address

315 14TH St E
Tifton, GA 31794-4018
Phone (229) 313-5083

Other names 1

  • Georgia Dental Associates of Tifton Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Georgia Dental Associates LLC6 organizations share this tax ID, including this one
Part of
Georgia Dental Associates LLC

Other organizations with this tax ID 5

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

Locations

315 14th St E
Tifton, GA 31794
Phone (229) 313-5083

NPI Registry JSON

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1619516002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 14TH ST E",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944018",
            "telephone_number": "229-313-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 14TH ST E",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944018",
            "telephone_number": "229-313-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA DENTAL ASSOCIATES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORGIA DENTAL ASSOCIATES",
        "enumeration_date": "2020-01-02",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "HATCHER",
        "authorized_official_first_name": "NETTIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DIRECTOR OF  OPERATIONS",
        "authorized_official_telephone_number": "229-848-2685"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Georgia Dental Associates of Tifton",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Georgia Dental Associates of Tifton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tifton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.