NPIMap

Organization Active NPI

SRR LLC

Doing business as Simple Smiles Restorative And Cosmetic Dentistry

  • General Practice Dentistry
  • Woodstock, GA
National Provider Identifier
1710304373
Registry record updated Mar 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
LC20140000214 Issued in GA
Legal business name
SRR LLC
Doing business as
Simple Smiles Restorative And Cosmetic Dentistry
Practice address
114 Mirramont Lake Dr
Woodstock, GA 30189-8213
Phone
(770) 592-7000
Fax
(770) 517-7403
NPI assigned
Mar 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2014

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

Authorized official

Name
Mrs. Hiral Ankur Patel, RDHNPI 1508283177
Title
Owner/Manager
Phone
(706) 346-9516

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
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X LC20140000214 GA Primary

Addresses

Primary practice location

114 Mirramont Lake Dr
Woodstock, GA 30189-8213

Mailing address

114 Mirramont Lake Dr
Woodstock, GA 30189-8213
Phone (770) 592-7000

Other names 1

  • Simple Smiles Restorative And Cosmetic Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

114 Mirramont Lake Dr
Woodstock, GA 30189
Phone (706) 346-9516

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": "1395273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395360000000",
    "number": "1710304373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 MIRRAMONT LAKE DR",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301898213",
            "telephone_number": "770-592-7000",
            "fax_number": "770-517-7403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 MIRRAMONT LAKE DR",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301898213",
            "telephone_number": "770-592-7000",
            "fax_number": "770-517-7403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-20",
        "last_updated": "2014-03-21",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "HIRAL",
        "authorized_official_middle_name": "ANKUR",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "706-346-9516",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "LC20140000214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Simple Smiles Restorative And Cosmetic Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2014; 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.