Herrin CPDS PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN014185 Issued in GA

Legal business name

HERRIN CPDS PC

Practice address

3006 Clairmont Rd NE Ste 100
Brookhaven, GA 30329-1602

Phone

(844) 682-4737

Fax

(404) 521-4044

NPI assigned

Dec 14, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Marcus Quran Polk, MD

Title

Practice Manager

Phone

(404) 403-4567

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Centers for Pediatric Dental Sedation Doing business as

Locations

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

{
    "created_epoch": "1513209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780876800000",
    "number": "1629584586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370160",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300370160",
            "telephone_number": "404-403-4567",
            "fax_number": "404-521-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3006 CLAIRMONT RD NE STE 100",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303291602",
            "telephone_number": "844-682-4737",
            "fax_number": "404-521-4044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Marble Mill Rd NW Ste B",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300607954",
            "country_code": "US",
            "telephone_number": "844-682-4737",
            "fax_number": "404-521-4044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HERRIN CPDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-14",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A",
        "authorized_official_last_name": "POLK",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_middle_name": "QURAN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "404-403-4567",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN014185",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN013021",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN014898",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003198439A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centers for Pediatric Dental Sedation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marcus Johnson Haynes
• Toccara Haynes
• Taylor Thompson Heffner, CPNP - AC
• Casey Jane Henritz, DO
• Kristina Herndon, CPNP-PC
• Stacy Jacobson Heyman, OT
• Chantai Hightower, NP
• Wauketa Hill, RBT
• Rodniqua Hines, LCSW
• Samantha Jean Hines, MS, BCBA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; 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.