NPIMap

Organization Active NPI

Coleman Dental Associates, PC

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1710131545
Registry record updated Nov 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN010307 Issued in GA
Legal business name
COLEMAN DENTAL ASSOCIATES, PC
Practice address
970 Martin Luther King Jr Dr SW
Suite 301
Atlanta, GA 30314-2962
Phone
(404) 523-3153
Fax
(404) 523-0136
NPI assigned
Nov 6, 2008
Last updated
Nov 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2008

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

Authorized official

Name
Dr. Marla O. Coleman, DDSNPI 1386639284
Title
President
Phone
(404) 523-3153

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN010307 GA Primary
Pediatric Dentistry 1223P0221X DN013127 GA

Addresses

Primary practice location

970 Martin Luther King Jr Dr SW
Suite 301
Atlanta, GA 30314-2962

Mailing address

970 Martin Luther King Jr Dr SW
Suite 301
Atlanta, GA 30314-2962
Phone (404) 523-3153

Other identifiers 2

IdentifierTypeStateIssuer
000364823AMedicaidGA
692906293AMedicaidGA

National Provider Directory

National Provider Directory

Locations

970 Martin Luther King Jr Dr SW
Ste 301
Atlanta, GA 30314
Phone (404) 523-3153

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225929600000",
    "number": "1710131545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 MARTIN LUTHER KING JR DR SW",
            "address_2": "SUITE 301",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303142962",
            "telephone_number": "404-523-3153",
            "fax_number": "404-523-0136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 MARTIN LUTHER KING JR DR SW",
            "address_2": "SUITE 301",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303142962",
            "telephone_number": "404-523-3153",
            "fax_number": "404-523-0136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLEMAN DENTAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-06",
        "last_updated": "2008-11-06",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "MARLA",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-523-3153",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN010307",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN013127",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000364823A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "692906293A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2008; 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.