Individual provider Active NPI

Christian Leigh Buckner, RDH, BS

  • Dental Hygienist
  • Sandy Springs, GA
National Provider Identifier
1730718446
Registry record updated Apr 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH011476 Issued in GA
Practice address
5014 Roswell Rd
Sandy Springs, GA 30342-2207
Phone
(404) 847-9711
NPI assigned
Apr 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DH011476 GA Primary

Addresses

Primary practice location

5014 Roswell Rd
Sandy Springs, GA 30342-2207

Mailing address

10114 Windalier Way
Roswell, GA 30076-1777

Other identifiers 1

IdentifierTypeStateIssuer
124Q00000XOtherGADENTISTRY 12

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdixon@georgiasmiles.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
DH011476GAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Atl Center for Cosmetic Dentistry LLC CurrentSince Aug 13, 2023 Accepting new patients
Debra Gray King, DDS PC PastSince Apr 17, 2020 Accepting new patients

Locations

5014 Roswell Rd
Sandy Springs, GA 30342
Phone (404) 847-9711

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1585958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585958400000",
    "number": "1730718446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10114 WINDALIER WAY",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5014 ROSWELL RD",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303422207",
            "telephone_number": "404-847-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKNER",
        "first_name": "CHRISTIAN",
        "middle_name": "LEIGH",
        "credential": "RDH, BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-04",
        "last_updated": "2020-04-04",
        "certification_date": "2020-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "GA",
            "license": "DH011476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTISTRY 12",
            "identifier": "124Q00000X",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdixon@georgiasmiles.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "email",
            "address_1": "5014 Roswell Rd",
            "city": "Sandy Springs",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303422207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sandy Springs, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2020; 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.