NPIMap

Organization Active NPI

Grant Park Dental Group PC

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1679877005
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN013218 Issued in GA
Legal business name
GRANT PARK DENTAL GROUP PC
Practice address
465 Boulevard SE Ste 207a
Atlanta, GA 30312-3483
Phone
(404) 624-1230
Fax
(404) 624-1210
NPI assigned
Dec 28, 2010
Last updated
Dec 28, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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

Authorized official

Name
Ashish Pravin Vakharia, DMDNPI 1508917329
Title
President
Phone
(412) 716-7907

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DN013218 GA Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DN012466 GA

Addresses

Primary practice location

465 Boulevard SE Ste 207a
Atlanta, GA 30312-3483

Mailing address

465 Boulevard SE Ste 207a
Atlanta, GA 30312-3483
Phone (404) 624-1230

National Provider Directory

National Provider Directory

Locations

465 Boulevard SE
Ste 207A
Atlanta, GA 30312
Phone (404) 624-1230

Practitioners & affiliated clinicians

Practitioners 3

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": "1293494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293494400000",
    "number": "1679877005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 BOULEVARD SE STE 207A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303123483",
            "telephone_number": "404-624-1230",
            "fax_number": "404-624-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 BOULEVARD SE STE 207A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303123483",
            "telephone_number": "404-624-1230",
            "fax_number": "404-624-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT PARK DENTAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-28",
        "last_updated": "2010-12-28",
        "status": "A",
        "authorized_official_last_name": "VAKHARIA",
        "authorized_official_first_name": "ASHISH",
        "authorized_official_middle_name": "PRAVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "412-716-7907",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013218",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012466",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 28, 2010; 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.