NPIMap

Organization Active NPI

Mark a Fitzgerald DMD PC

  • General Practice Dentistry
  • Cartersville, GA
National Provider Identifier
1659482891
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN010780 Issued in GA
Legal business name
MARK A FITZGERALD DMD PC
Doing business as
Allatonna Family Dental
Practice address
100 Courtyard Drive
Cartersville, GA 30120
Phone
(770) 382-5678
Fax
(770) 382-1108
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mark Anthony Fitzgerald, DMDNPI 1699868794
Title
President
Phone
(770) 382-5678

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
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X DN010780 GA Primary

Addresses

Primary practice location

100 Courtyard Drive
Cartersville, GA 30120

Mailing address

100 Courtyard Drive
Cartersville, GA 30120
Phone (770) 382-5678

Other identifiers 1

IdentifierTypeStateIssuer
277431OtherUNITED CONCORDIA CO INS

Other names 1

  • Allatonna Family Dental Doing business as

National Provider Directory

National Provider Directory

Locations

100 Courtyard Dr SE
Cartersville, GA 30120
Phone (770) 382-5678

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659482891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 COURTYARD DRIVE",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "30120",
            "telephone_number": "770-382-5678",
            "fax_number": "770-382-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COURTYARD DRIVE",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "30120",
            "telephone_number": "770-382-5678",
            "fax_number": "770-382-1108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A FITZGERALD DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-382-5678",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN010780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA CO INS",
            "identifier": "277431",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allatonna Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cartersville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.