Radiant Smiles Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

RADIANT SMILES DENTAL LLC

Practice address

587 Virginia Ave NE Ste 5
Atlanta, GA 30306-3688

Phone

(404) 389-0700

NPI assigned

Dec 13, 2011

Last updated

Dec 13, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Grace Wu, DDS

Title

Managing Partner

Phone

(404) 389-0700

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1323734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323734400000",
    "number": "1760750202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "587 VIRGINIA AVE NE STE 5",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303063688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "587 VIRGINIA AVE NE STE 5",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303063688",
            "telephone_number": "404-389-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANT SMILES DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-13",
        "last_updated": "2011-12-13",
        "status": "A",
        "authorized_official_last_name": "WU",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "404-389-0700",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Atlanta, GA
• Providers in Atlanta, 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 Dec 13, 2011; 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.