Oakwood Smiles PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN013149 Issued in GA

Legal business name

OAKWOOD SMILES PC

Practice address

4038 Mundy Mill Rd
Oakwood, GA 30566-2518

Phone

(770) 534-4292

NPI assigned

Mar 23, 2009

Last updated

Dec 7, 2012By 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

Sergey GritsivNPI 1104893742

Title

President

Phone

(770) 534-4292

Specialties & licenses 1

Addresses

Locations

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.

• Sergey Valerieyvich Gritsiv, DMD

  • Dentist
  • Oakwood, GA
  • NPI 1104893742
  NPD (past) Authorized official

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

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354838400000",
    "number": "1770724619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19",
            "city": "OAKWOOD",
            "state": "GA",
            "postal_code": "305660001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4038 MUNDY MILL RD",
            "city": "OAKWOOD",
            "state": "GA",
            "postal_code": "305662518",
            "telephone_number": "770-534-4292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKWOOD SMILES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-23",
        "last_updated": "2012-12-07",
        "status": "A",
        "authorized_official_last_name": "GRITSIV",
        "authorized_official_first_name": "SERGEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-534-4292"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Point Lighthouse Counseling, LLC
• Kelly Nicole O'Dell, M.D.
• Oakwood Eye Associates (Elan Eye of Oakwood)
• Oakwood Family Dental LLC
• Oakwood Medical Clinic
• Oluwatobiloba Oladejo
• Tolulope Abiodun Olunuga, M.D.
• Prachi Patel, DMD
• Tejal A Patel, PHARM D. M.B.A
• Dawn Pawlik

• General Practice Dentistry in Oakwood, GA
• Providers in Oakwood, 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 7, 2012; 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.