Hannah H Clifford, DDS
Individual provider Active NPI Dentist · Liburn, GA
NPI 1700876166 · NPPES record last updated Dec 30, 2021
Key facts
- NPI
- 1700876166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DN01587 (GA)
- Practice address
- 449 Pleasant Hill Rd
#101
Liburn, GA 30047 - Phone
- (770) 797-5221
- Fax
- (773) 278-5043
- NPI assigned
- Oct 26, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN01587 | GA | MD | Dentist |
| 319014794 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Village Family Dental LLC | Dentist | Current | Accepting new patients |
| Ogando DDS LLC | Past |
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN01587 | GA | Yes |
| 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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1005607 | Medicaid | IL |
Other names
- Hannah Kim
Other providers in Liburn, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 30, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.