NPIMap

Organization Active NPI

M Forest Butler DDS Ms PC

Doing business as Gwinnett Dental Implant Center

  • Periodontics
  • Lilburn, GA
National Provider Identifier
1679977656
Registry record updated Oct 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
7999 Issued in GA
Legal business name
M FOREST BUTLER DDS MS PC
Doing business as
Gwinnett Dental Implant Center
Practice address
320 Killian Hill Rd NW
Lilburn, GA 30047-3809
Phone
(770) 921-3555
Fax
(770) 564-2244
NPI assigned
Oct 20, 2014
Last updated
Oct 20, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2014

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

Authorized official

Name
Dr. Milton Forest Butler, DDSNPI 1619995917
Title
Owner
Phone
(770) 921-3555

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 7999 GA Primary

Addresses

Primary practice location

320 Killian Hill Rd NW
Lilburn, GA 30047-3809

Mailing address

320 Killian Hill Rd NW
Lilburn, GA 30047-3809
Phone (770) 921-3555

Other names 1

  • Gwinnett Dental Implant Center Doing business as

National Provider Directory

National Provider Directory

Locations

320 Killian Hill Rd NW
Lilburn, GA 30047
Phone (770) 921-3555

Practitioners & affiliated clinicians

Practitioners 2

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": "1413763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413763200000",
    "number": "1679977656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 KILLIAN HILL RD NW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473809",
            "telephone_number": "770-921-3555",
            "fax_number": "770-564-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 KILLIAN HILL RD NW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473809",
            "telephone_number": "770-921-3555",
            "fax_number": "770-564-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M FOREST BUTLER DDS MS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-20",
        "last_updated": "2014-10-20",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "MILTON",
        "authorized_official_middle_name": "FOREST",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-921-3555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "GA",
            "license": "7999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gwinnett Dental Implant Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lilburn, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2014; 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.