NPIMap

Organization Active NPI

Smdentalpc

Doing business as East Atlanta Family Dental

  • Exclusive Provider Organization
  • Atlanta, GA
National Provider Identifier
1649678921
Registry record updated Dec 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
DN012987 Issued in GA
Legal business name
SMDENTALPC
Doing business as
East Atlanta Family Dental
Practice address
440 Flat Shoals Ave SE
Atlanta, GA 30316-1915
Phone
(404) 688-2223
Fax
(404) 688-6602
NPI assigned
Dec 18, 2014
Last updated
Dec 18, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2014

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

Authorized official

Name
Dr. Shervin Meshkian, DDSNPI 1558472001
Title
Dentist/Ceo
Phone
(404) 688-2223

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X DN012987 GA Primary

Addresses

Primary practice location

440 Flat Shoals Ave SE
Atlanta, GA 30316-1915

Mailing address

440 Flat Shoals Ave SE
Atlanta, GA 30316-1915
Phone (404) 688-2223

Other identifiers 1

IdentifierTypeStateIssuer
003147751BMedicaidGA

Other names 1

  • East Atlanta Family Dental Doing business as

National Provider Directory

National Provider Directory

Locations

440 Flat Shoals Ave SE
Atlanta, GA 30316
Phone (404) 688-2223

Practitioners & affiliated clinicians

Practitioners 2

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": "1418860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418860800000",
    "number": "1649678921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 FLAT SHOALS AVE SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303161915",
            "telephone_number": "404-688-2223",
            "fax_number": "404-688-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 FLAT SHOALS AVE SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303161915",
            "telephone_number": "404-688-2223",
            "fax_number": "404-688-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMDENTALPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-18",
        "last_updated": "2014-12-18",
        "status": "A",
        "authorized_official_last_name": "MESHKIAN",
        "authorized_official_first_name": "SHERVIN",
        "authorized_official_title_or_position": "DENTIST/CEO",
        "authorized_official_telephone_number": "404-688-2223",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "GA",
            "license": "DN012987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003147751B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Atlanta Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; 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.