Kids Zone Dentistry & Lagrange Family Dental

Primary specialty

DentistTaxonomy code 122300000X

License

DN009828 Issued in GA

Legal business name

KIDS ZONE DENTISTRY & LAGRANGE FAMILY DENTAL

Practice address

307 Church St Ste a
Lagrange, GA 30240-2700

Phone

(706) 882-0591

Fax

(706) 845-9546

NPI assigned

Aug 14, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Chuck Pitts, D.M.D

Title

Owner

Phone

(706) 882-0591

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

C H Pitts Enterprises Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• C H Pitts Enterprises, Inc.

  • Dentist
  • Lagrange, GA
  • NPI 1750633319
  NPD tax ID

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

{
    "created_epoch": "1376438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376438400000",
    "number": "1669805503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 CHURCH ST STE A",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302402700",
            "telephone_number": "706-882-0591",
            "fax_number": "706-845-9546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 CHURCH ST STE A",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302402700",
            "telephone_number": "706-882-0591",
            "fax_number": "706-845-9546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS ZONE DENTISTRY & LAGRANGE FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-14",
        "last_updated": "2013-08-14",
        "status": "A",
        "authorized_official_last_name": "PITTS",
        "authorized_official_first_name": "CHUCK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-882-0591",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN009828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191678896B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Douglas Brent Kersey Jr., DMD
• Meredith Key, ED.S., LPC, NCC
• Kid Station Pediatrics P.C
• Kid'S Zone Dentistry, LLC
• Kids Zone Behavioral Health, Inc
• James G Killebrew Jr., M.D.
• Jinah Kim
• Joo Young Kim, PHARMD
• Katie Kinsey, PP, BS
• Loletha Kirkland

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; 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.