Camp Creek Smiles Family Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

CAMP CREEK SMILES FAMILY DENTISTRY

Practice address

3890 Redwine Rd SW
Ste 108
Atlanta, GA 30331-5582

Phone

(404) 344-7645

Fax

(404) 696-2883

NPI assigned

Dec 3, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Paul R McKoy, DDS

Title

Dentist

Phone

(404) 344-7645

Specialties & licenses 1

Addresses

Practitioners 1

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

• Ericka M Edmonds, DDS

  • General Practice Dentistry
  • Atlanta, GA
  • NPI 1952360265
  NPD (past)

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

{
    "created_epoch": "1259798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259798400000",
    "number": "1770811713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3890 REDWINE RD SW",
            "address_2": "STE 108",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303315582",
            "telephone_number": "404-344-7645",
            "fax_number": "404-696-2883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 REDWINE RD SW",
            "address_2": "STE 108",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303315582",
            "telephone_number": "404-344-7645",
            "fax_number": "404-696-2883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMP CREEK SMILES FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-03",
        "last_updated": "2009-12-03",
        "status": "A",
        "authorized_official_last_name": "MCKOY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "404-344-7645",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camp Creek LLC
• Camp Creek Pediatrics LLC
• Camp Creek Pharmacy LLC
• Camp Creek Primary Care, PC
• Camp Creek Smiles
• Camp Creek Urgent Care LLC
• Camp Creek Village Pharmacy Inc.
• Camp Creek Women'S Health Center
• Camp Creek Women'S Health Center, LLC
• Camp Creek Women'S Health Specialist

• Dental Clinic/Center in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Dental Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2009; 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.