Individual provider Active NPI

Hannah H Clifford, DDS

  • Dentist
  • Liburn, GA
National Provider Identifier
1700876166
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN01587 Issued in GA
Practice address
449 Pleasant Hill Rd
#101
Liburn, GA 30047
Phone
(770) 797-5221
Fax
(773) 278-5043
NPI assigned
Oct 26, 2005
Last updated
Dec 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN01587 GA Primary
Dentist 122300000X 319014794 IL

Addresses

Primary practice location

449 Pleasant Hill Rd
#101
Liburn, GA 30047

Mailing address

449 Pleasant Hill Rd
#101
Liburn, GA 30047
Phone (770) 797-5221

Other names 1

  • Hannah Kim Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN01587GAMDDentist
319014794ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Village Family Dental LLC Dentist Current Accepting new patients
Ogando DDS LLC PastSince Jun 5, 2022 Accepting new patients
West Town Dental Group Dentist Past Accepting new patients

Locations

449 Pleasant Hill Rd NW
Ste 101
Lilburn, GA 30047
Phone (770) 564-9906

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1700876166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "449 PLEASANT HILL RD",
            "address_2": "#101",
            "city": "LIBURN",
            "state": "GA",
            "postal_code": "30047",
            "telephone_number": "770-797-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "449 PLEASANT HILL RD",
            "address_2": "#101",
            "city": "LIBURN",
            "state": "GA",
            "postal_code": "30047",
            "telephone_number": "770-797-5221",
            "fax_number": "773-278-5043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFFORD",
        "first_name": "HANNAH",
        "middle_name": "H",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN01587",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "319014794",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HANNAH",
            "last_name": "KIM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Liburn, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.