Organization Active NPI

Your Joyful Smile Dental-Tucker, LLC

  • General Practice Dentistry
  • Tucker, GA
National Provider Identifier
1700467602
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
YOUR JOYFUL SMILE DENTAL-TUCKER, LLC
Practice address
3577 Habersham at Northlake BLDG L
Tucker, GA 30084-4001
Phone
(404) 289-2772
Fax
(404) 289-1139
NPI assigned
Apr 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Authorized official

Name
Dr. Terrance DMD Jeter, DMD
Title
President
Phone
(404) 289-2772

Specialties & licenses 1

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

Addresses

Primary practice location

3577 Habersham at Northlake BLDG L
Tucker, GA 30084-4001

Mailing address

1770 Candler Rd
Decatur, GA 30032-3277
Phone (404) 289-2772

Other names 1

  • DR. TERRANCE L. JETER & ASSOCIATES, TUCKER Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL info@drtjeter.com Direct

National Provider Directory

National Provider Directory

Locations

1770 Candler Rd
Decatur, GA 30032
Phone (404) 289-2772

3577 Habersham At Northlake
Bldg L
Tucker, GA 30084
Phone (404) 289-2772

Practitioners & affiliated clinicians

Practitioners 2

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": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1700467602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 CANDLER RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300323277",
            "telephone_number": "404-289-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3577 HABERSHAM AT NORTHLAKE BLDG L",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844001",
            "telephone_number": "404-289-2772",
            "fax_number": "404-289-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR JOYFUL SMILE DENTAL-TUCKER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A",
        "authorized_official_last_name": "JETER",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_middle_name": "DMD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-289-2772",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "info@drtjeter.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3577 Habersham At Northlake Bldg L",
            "city": "Tucker",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300844001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "DR. TERRANCE L. JETER & ASSOCIATES, TUCKER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucker, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.