NPIMap

Organization Active NPI

Edgewood Dental Center

  • Dental Clinic/Center
  • Atlanta, GA
National Provider Identifier
1770834954
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
EDGEWOOD DENTAL CENTER
Practice address
545 Edgewood Ave SE
Atlanta, GA 30312-1936
Phone
(404) 589-0900
Fax
(404) 537-3107
NPI assigned
Sep 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Authorized official

Name
Nikki Rolls
Title
Insurance Manager
Phone
(404) 758-0770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X GA Primary

Addresses

Primary practice location

545 Edgewood Ave SE
Atlanta, GA 30312-1936

Mailing address

545 Edgewood Ave SE
Atlanta, GA 30312-1936
Phone (404) 589-0900

National Provider Directory

National Provider Directory

Locations

545 Edgewood Ave SE
Atlanta, GA 30312
Phone (404) 589-0900

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1348704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348704000000",
    "number": "1770834954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 EDGEWOOD AVE SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121936",
            "telephone_number": "404-589-0900",
            "fax_number": "404-537-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 EDGEWOOD AVE SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121936",
            "telephone_number": "404-589-0900",
            "fax_number": "404-537-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-27",
        "last_updated": "2012-09-27",
        "status": "A",
        "authorized_official_last_name": "ROLLS",
        "authorized_official_first_name": "NIKKI",
        "authorized_official_title_or_position": "INSURANCE MANAGER",
        "authorized_official_telephone_number": "404-758-0770"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.