Center for Cosmetic and Sedation Dentistry Johns Creek, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

CENTER FOR COSMETIC AND SEDATION DENTISTRY JOHNS CREEK, LLC

Practice address

3440 Old Alabama Rd
Johns Creek, GA 30022-5525

Phone

(770) 475-0603

Fax

(770) 753-8893

NPI assigned

Jan 10, 2022

Organization subpart

No

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

Authorized official

Name

Donna Tidwell

Title

Insurance Manager

Phone

(770) 995-1957

Specialties & licenses 1

Addresses

Other names 1

• Center For Cosmetic And Sedation Dentistry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gary E Taylor, DDS

  • General Practice Dentistry
  • Alpharetta, GA
  • NPI 1164572350
  NPD (past)

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678060800000",
    "number": "1619638814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 OLD ALABAMA RD",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300225525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 OLD ALABAMA RD",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300225525",
            "telephone_number": "770-475-0603",
            "fax_number": "770-753-8893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR COSMETIC AND SEDATION DENTISTRY JOHNS CREEK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-10",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "TIDWELL",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "INSURANCE MANAGER",
        "authorized_official_telephone_number": "770-995-1957"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center For Cosmetic And Sedation Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Center For Cosmetic And Sedation Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jenny Casteel
• Lissette Castrejon
• Savannah Lauren Cato
• Kelly D Caulley, CNP
• CDZ Ortho, LLC
• Centrix Homecare LLC
• Alexandria Cerione
• Sukit Chaiyachati, M.D.
• Supriya Pravin Chakre
• Nandita Chandran, DMD

• Dental Clinic/Center in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• Dental Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; 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.