NPIMap

Organization Active NPI

Georgia Dental Professionals, PC

Doing business as Dental Care at Rose Creek

  • General Practice Dentistry
  • Woodstock, GA
National Provider Identifier
1780220194
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
GEORGIA DENTAL PROFESSIONALS, PC
Doing business as
Dental Care at Rose Creek
Practice address
4355 Towne Lake Pkwy
Woodstock, GA 30189-8150
Phone
(678) 905-0211
NPI assigned
Nov 20, 2019
Last updated
Mar 11, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
GEORGIA DENTAL PROFESSIONALS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

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

Authorized official

Name
Jessica Britt
Title
Credentialing Coordinator
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

4355 Towne Lake Pkwy
Woodstock, GA 30189-8150

Mailing address

4355 Towne Lake Pkwy
Woodstock, GA 30189-8150
Phone (770) 627-0319

Other names 1

  • Dental Care at Rose Creek Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Dental Care of Georgia72 organizations share this tax ID, including this one
Part of
Heartland Dental Care of Georgia

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

4355 Towne Lake Pkwy
Woodstock, GA 30189
Phone (678) 905-0211

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1574208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583884800000",
    "number": "1780220194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4355 TOWNE LAKE PKWY",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301898150",
            "telephone_number": "770-627-0319",
            "fax_number": "770-639-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4355 TOWNE LAKE PKWY",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301898150",
            "telephone_number": "678-905-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA DENTAL PROFESSIONALS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORGIA DENTAL PROFESSIONALS, PC",
        "enumeration_date": "2019-11-20",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A",
        "authorized_official_last_name": "BRITT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care at Rose Creek",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dental Care at Rose Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; 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.