Kool Smiles PTC PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN011874 Issued in GA

Legal business name

KOOL SMILES PTC PC

Practice address

400 Galleria Pkwy SE
Suite 800
Atlanta, GA 30339-5980

Phone

(678) 904-5665

NPI assigned

Jun 7, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Dale Gary Mayfield, DMD

Title

Dentist

Phone

(678) 904-5665

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689877557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 GALLERIA PKWY SE",
            "address_2": "SUITE 800",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395980",
            "telephone_number": "678-904-5665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 GALLERIA PKWY SE",
            "address_2": "SUITE 800",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395980",
            "telephone_number": "678-904-5665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOOL SMILES PTC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAYFIELD",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "678-904-5665",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN011874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Alex Kontos III, PSYD
• Andee Koo
• Beth Kooby, N.P.
• David Kooby, MD
• Hyung Mi Kook, OTRL
• Ronald Koon, PHD
• Gagandeep Kooner, MD
• Gretchen L Koontz, MD
• Robert Koontz, PH.D
• Alan R Koornick, MD

• General Practice Dentistry in Atlanta, GA
• Providers in Atlanta, 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 Aug 22, 2020; 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.