NPIMap

Organization Active NPI

Peach Smiles

  • Dentist
  • Lawrenceville, GA
National Provider Identifier
1639856552
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PEACH SMILES
Practice address
4825 Sugarloaf Pkwy Ste a
Lawrenceville, GA 30044-8800
Phone
(770) 609-6620
NPI assigned
Jul 3, 2023
Last updated
Jul 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Authorized official

Name
Praveen R Gudipati, DMDNPI 1700080793
Title
Dentist Owner
Phone
(404) 966-7766

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

4825 Sugarloaf Pkwy Ste a
Lawrenceville, GA 30044-8800

Mailing address

4825 Sugarloaf Pkwy Ste a
Lawrenceville, GA 30044-8800
Phone (770) 609-6620

National Provider Directory

National Provider Directory

Locations

4825 Sugarloaf Pkwy
Ste A
Lawrenceville, GA 30044
Phone (770) 609-6620

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688342400000",
    "number": "1639856552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4825 SUGARLOAF PKWY STE A",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300448800",
            "telephone_number": "770-609-6620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4825 SUGARLOAF PKWY STE A",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300448800",
            "telephone_number": "770-609-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH SMILES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-03",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-02",
        "status": "A",
        "authorized_official_last_name": "GUDIPATI",
        "authorized_official_first_name": "PRAVEEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "404-966-7766",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.