NPIMap

Organization Active NPI

Georgia Dental Professionals, PC

Doing business as Riverwood Dental Care

  • General Practice Dentistry
  • Evans, GA
National Provider Identifier
1710478102
Registry record updated Nov 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
GEORGIA DENTAL PROFESSIONALS, PC
Doing business as
Riverwood Dental Care
Practice address
5131 Washington Rd
Evans, GA 30809
Phone
(217) 540-5100
NPI assigned
May 22, 2018
Last updated
Nov 15, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
GEORGIA DENTAL PROFESSIONALS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 15, 2018

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

Authorized official

Name
Jessica Britt
Title
Credentialing Coordinator
Phone
(217) 540-8426

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

5131 Washington Rd
Evans, GA 30809

Mailing address

5131 Washington Rd
Evans, GA 30809-6445
Phone (706) 550-1884

Other names 1

  • Riverwood Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Georgia Dental Professionals PC72 organizations share this tax ID, including this one
Part of
Georgia Dental Professionals PC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

3350 Riverwood Pkwy SE
Ste 2120
Atlanta, GA 30339
Phone (770) 830-3967

5131 Washington Rd
Evans, GA 30809
Phone (706) 550-1658

9596 Bentley Dr
Grovetown, GA 30813
Phone (706) 305-9560

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 6

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": "1526947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542240000000",
    "number": "1710478102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5131 WASHINGTON RD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308096445",
            "telephone_number": "706-550-1884",
            "fax_number": "706-550-1885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5131 WASHINGTON RD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "30809",
            "telephone_number": "217-540-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA DENTAL PROFESSIONALS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORGIA DENTAL PROFESSIONALS, PC",
        "enumeration_date": "2018-05-22",
        "last_updated": "2018-11-15",
        "status": "A",
        "authorized_official_last_name": "BRITT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8426"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverwood Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evans, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; 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.