NPIMap

Organization Active NPI

Comprehensive Dental Center

Doing business as Smiles on Main

  • Dentist
  • Alpharetta, GA
National Provider Identifier
1740308576
Registry record updated Nov 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN012835 Issued in GA
Legal business name
COMPREHENSIVE DENTAL CENTER
Doing business as
Smiles on Main
Practice address
342 N Main St
Suite 110
Alpharetta, GA 30004-8376
Phone
(678) 762-1613
Fax
(678) 762-1689
NPI assigned
Mar 27, 2007
Last updated
Nov 13, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2014

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

Authorized official

Name
Dr. Ketankumar G Patel, D.M.D.
Title
Dentist
Phone
(678) 762-1613

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X DN012835 GA Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X DN008017 GA
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X DN007359 GA

Addresses

Primary practice location

342 N Main St
Suite 110
Alpharetta, GA 30004-8376

Mailing address

342 N Main St
Suite 110
Alpharetta, GA 30004-8376
Phone (678) 762-1613

Other identifiers 1

IdentifierTypeStateIssuer
500129458BMedicaidGA

Other names 1

  • Smiles on Main Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Comprehensive Dental Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

342 N Main St
Ste 110
Alpharetta, GA 30009
Phone (678) 762-1613

Practitioners & affiliated clinicians

Practitioners 1

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": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415836800000",
    "number": "1740308576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 N MAIN ST",
            "address_2": "SUITE 110",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300048376",
            "telephone_number": "678-762-1613",
            "fax_number": "678-762-1689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 N MAIN ST",
            "address_2": "SUITE 110",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300048376",
            "telephone_number": "678-762-1613",
            "fax_number": "678-762-1689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2014-11-13",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "KETANKUMAR",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "678-762-1613",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN012835",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN008017",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN007359",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500129458B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smiles on Main",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.