City Dental Clinic 247 LTD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CITY DENTAL CLINIC 247 LTD

Practice address

3280 Old Alabama Rd Ste 200
Johns Creek, GA 30022-8544

Phone

(770) 263-8408

Fax

(770) 263-8744

NPI assigned

Jun 12, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Ifeanyi Ezunu, DDSNPI 1588603971

Title

Owner

Phone

(770) 263-8408

Specialties & licenses 1

Addresses

Other names 1

• City Dental Clinic Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ifeanyi N. Ezunu, DDS

  • General Practice Dentistry
  • Norcross, GA
  • NPI 1588603971
  NPD Authorized official

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1750123485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3280 OLD ALABAMA RD STE 200",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300228544",
            "telephone_number": "770-263-8408",
            "fax_number": "770-263-8744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 OLD ALABAMA RD STE 200",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300228544",
            "telephone_number": "770-263-8408",
            "fax_number": "770-263-8744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY DENTAL CLINIC 247 LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "EZUNU",
        "authorized_official_first_name": "IFEANYI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-263-8408",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "City Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michelle Chun
• Gene Chung, DMD
• Jane Chung, MD
• Rebecca C Ciccarelli, MS CCC/SLP
• Cimarron Physical Therapy Inc
• CKS Loving Care LLC
• Kirsten Coffey Clarke, MS, CCC-SLP
• Natalie Lauren Clericuzio, MD
• Linda P Cobaugh, MMT, MT-BC
• Shantelle Coe, NP

• General Practice Dentistry in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.