Peach Smiles

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

Organization subpart

No

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

Authorized official

Name

Praveen R Gudipati, DMD

Title

Dentist Owner

Phone

(404) 966-7766

Specialties & licenses 1

Addresses

Locations

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": []
}

• Tik Pau, M.D.
• Albin Paul, DC
• Brittney Y Paul
• Jacklyn Paumig
• William George Paxton, M.D., PH.D.
• Peach State Home Care Service LLC
• Peach State Pediatric Therapy Inc.
• Peach State Smiles
• Peachtree MRI LLC
• Aurora J. Peacock, MD

• Dentist in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Dentist in Georgia

• 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.