NPIMap

Organization Active NPI

Peachtree Childrens Dentistry Gainesville LLC

  • Pediatric Dentistry
  • Gainesville, GA
National Provider Identifier
1760921480
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
PEACHTREE CHILDRENS DENTISTRY GAINESVILLE LLC
Practice address
885 Dawsonville Hwy.
Suite 1130
Gainesville, GA 30501
Phone
(770) 497-0110
NPI assigned
Feb 14, 2017
Last updated
Feb 14, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

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

Authorized official

Name
Nameun Nancy Kil, DDSNPI 1912944562
Title
Co-Owner
Phone
(678) 438-1833

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X Primary

Addresses

Primary practice location

885 Dawsonville Hwy.
Suite 1130
Gainesville, GA 30501

Mailing address

885 Dawsonville Hwy.
Suite 1130
Gainesville, GA 30501

National Provider Directory

National Provider Directory

Locations

885 Dawsonville Hwy
Ste 1130
Gainesville, GA 30501
Phone (678) 696-8878

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": "1487030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487030400000",
    "number": "1760921480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 DAWSONVILLE HWY.",
            "address_2": "SUITE 1130",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 DAWSONVILLE HWY.",
            "address_2": "SUITE 1130",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30501",
            "telephone_number": "770-497-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE CHILDRENS DENTISTRY GAINESVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-14",
        "last_updated": "2017-02-14",
        "status": "A",
        "authorized_official_last_name": "KIL",
        "authorized_official_first_name": "NAMEUN",
        "authorized_official_middle_name": "NANCY",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "678-438-1833",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; 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.