Peachtree Children'S Dentistry Snellville

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

PEACHTREE CHILDREN'S DENTISTRY SNELLVILLE

Practice address

1905 Scenic Hwy N Ste 510
Snellville, GA 30078-5635

Phone

(770) 979-6400

Fax

(770) 979-7465

NPI assigned

Jan 22, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Tamara M Cox, CDA

Title

Office Manager

Phone

(770) 979-6400

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

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

• Nam Eun Kil, DDS

  • Pediatric Dentistry
  • Duluth, GA
  • NPI 1912944562
  NPD (past)
• Demetris Estella Rush, DDS

  • Pediatric Dentistry
  • Duluth, GA
  • NPI 1841237476
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366070400000",
    "number": "1750434643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 SCENIC HWY N STE 510",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300785635",
            "telephone_number": "770-979-6400",
            "fax_number": "770-979-7465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 SCENIC HWY N STE 510",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300785635",
            "telephone_number": "770-979-6400",
            "fax_number": "770-979-7465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE CHILDREN'S DENTISTRY SNELLVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2013-04-16",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-979-6400",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CDA"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000949616C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000947944C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• E. Victor Pavamani, M.D.
• Leticia D Payne, ED.S CCC-SLP
• Marshika Pazant
• Jaye Lynn Peabody, LAPC, NCC
• Peace of Hope, Inc.
• Peachtree Immediate Care FP, LLC
• Marjorie Peden, LPC
• Pediatric Therapy on the Go LLC
• Warren Terry Peeples II
• Rolando Argeniz Pena-Larios, PTA

• Pediatric Dentistry in Snellville, GA
• Providers in Snellville, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2013; 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.