Organization Active NPI

Imagix Dental of Norcross LLC

  • Dentist
  • Norcross, GA
National Provider Identifier
1710358841
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
IMAGIX DENTAL OF NORCROSS LLC
Practice address
5270 Peachtree Pkwy Ste 101
Norcross, GA 30092-2558
Phone
(770) 448-9333
Fax
(678) 990-0359
NPI assigned
Oct 15, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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

Authorized official

Name
Mike Cole
Title
VP Insurance Plan Management
Phone
(727) 726-1611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X GA Primary

Addresses

Primary practice location

5270 Peachtree Pkwy Ste 101
Norcross, GA 30092-2558

Mailing address

5270 Peachtree Pkwy Ste 101
Norcross, GA 30092-2558

National Provider Directory

National Provider Directory

Locations

5270 Peachtree Pkwy
Ste 101
Norcross, GA 30092
Phone (770) 448-9333

Practitioners & affiliated clinicians

Practitioners 1

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": "1444867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444867200000",
    "number": "1710358841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5270 PEACHTREE PKWY STE 101",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300922558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5270 PEACHTREE PKWY STE 101",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300922558",
            "telephone_number": "770-448-9333",
            "fax_number": "678-990-0359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGIX DENTAL OF NORCROSS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-15",
        "last_updated": "2015-10-15",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "VP INSURANCE PLAN MANAGEMENT",
        "authorized_official_telephone_number": "727-726-1611"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2015; 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.