VSM Aberdeen Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

VSM ABERDEEN DENTAL LLC

Practice address

71 Postal Pkwy
Newnan, GA 30263-2979

Phone

(770) 254-9332

NPI assigned

Nov 1, 2016

Organization subpart

No

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

Authorized official

Name

Jenni Snow

Title

Credentialing Coordinator

Phone

(404) 410-1340

Specialties & licenses 1

Addresses

Other names 1

• Aberdeen Dental Doing business as

Tax ID family

Aberdeen Dental2 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.

• Aberdeen Dental, LLC

  • General Practice Dentistry
  • Peachtree City, GA
  • NPI 1811966625
  NPD tax ID

Locations

Practitioners 2

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

• Marcus James Burk, DMD

  • General Practice Dentistry
  • Peachtree City, GA
  • NPI 1356864888
  NPD (past)
• Pamela Sehra, DDS, MPH, FAGD

  • Dentist
  • Newnan, GA
  • NPI 1922528157
  NPD (past)

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

{
    "created_epoch": "1477958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489363200000",
    "number": "1669924031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 TOWNPARK DR NW STE 70",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301443740",
            "telephone_number": "404-410-1340",
            "fax_number": "404-410-1345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 POSTAL PKWY",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302632979",
            "telephone_number": "770-254-9332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VSM ABERDEEN DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-01",
        "last_updated": "2017-03-13",
        "status": "A",
        "authorized_official_last_name": "SNOW",
        "authorized_official_first_name": "JENNI",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "404-410-1340"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aberdeen Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John David Vickery IV, M.D.
• Victory Health System, Inc.
• Village Podiatry Group LLC
• Vital Care Transports Inc
• Kent Alan Voyce, OD
• Margaret C Wade, RPH
• Ashley King Wafford, PA
• Stacey Waggoner, EMT-A
• Kurt Louis Wahnschaff
• Mary Catherine Waite

• General Practice Dentistry in Newnan, GA
• Providers in Newnan, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; 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.