NPIMap

Organization Active NPI

Georgia Dental Professionals, PC

Doing business as Dental Care at Mullins Colony

  • General Practice Dentistry
  • Evans, GA
National Provider Identifier
1679167290
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
GEORGIA DENTAL PROFESSIONALS, PC
Doing business as
Dental Care at Mullins Colony
Practice address
545 Mullins Colony Dr
Evans, GA 30809-0559
Phone
(706) 842-2215
NPI assigned
Feb 24, 2021
Last updated
Feb 24, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
GEORGIA DENTAL PROFESSIONALS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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

Authorized official

Name
Celia Hayes
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

545 Mullins Colony Dr
Evans, GA 30809-0559

Mailing address

545 Mullins Colony Dr
Evans, GA 30809-0559
Phone (706) 842-2215

Other names 1

  • Dental Care at Mullins Colony Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Dental Care of Georgia72 organizations share this tax ID, including this one
Part of
Heartland Dental Care of Georgia

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

545 Mullins Colony Dr
Evans, GA 30809
Phone (706) 842-2215

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 4

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": "1614124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614124800000",
    "number": "1679167290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 MULLINS COLONY DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308090559",
            "telephone_number": "706-842-2215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 MULLINS COLONY DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308090559",
            "telephone_number": "706-842-2215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA DENTAL PROFESSIONALS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORGIA DENTAL PROFESSIONALS, PC",
        "enumeration_date": "2021-02-24",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-05",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "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": "Dental Care at Mullins Colony",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evans, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; 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.