NPIMap

Organization Active NPI

DTJG Dental Group LLC

  • Dental Clinic/Center
  • Kennesaw, GA
National Provider Identifier
1700429115
Registry record updated Oct 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DTJG DENTAL GROUP LLC
Practice address
2430 Powell PL NW
Kennesaw, GA 30144-3567
Phone
(770) 424-1705
NPI assigned
Oct 18, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2019

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

Authorized official

Name
Dr. David Hildreth, DMDNPI 1073877825
Title
Dentist/Owner
Phone
(404) 664-3563

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

2430 Powell PL NW
Kennesaw, GA 30144-3567

Mailing address

351 Wesley Dr
Acworth, GA 30101-8727
Phone (404) 664-3563

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1571356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571356800000",
    "number": "1700429115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 WESLEY DR",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301018727",
            "telephone_number": "404-664-3563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 POWELL PL NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301443567",
            "telephone_number": "770-424-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DTJG DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-18",
        "last_updated": "2019-10-18",
        "status": "A",
        "authorized_official_last_name": "HILDRETH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "404-664-3563",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2019; 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.