NPIMap

Organization Active NPI

Town Dentistry Brookhaven, LLC

Doing business as Town Dentistry

  • General Practice Dentistry
  • Brookhaven, GA
National Provider Identifier
1780456301
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TOWN DENTISTRY BROOKHAVEN, LLC
Doing business as
Town Dentistry
Practice address
804 Town Blvd NE Ste 2010
Brookhaven, GA 30319-3147
Phone
(404) 631-6277
NPI assigned
Oct 26, 2023
Last updated
Oct 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Authorized official

Name
Heather Rae Frodge, DMDNPI 1528235116
Title
Owner
Phone
(404) 476-0814

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

804 Town Blvd NE Ste 2010
Brookhaven, GA 30319-3147

Mailing address

804 Town Blvd NE Ste 2010
Brookhaven, GA 30319-3147
Phone (404) 631-6277

Other names 1

  • Town Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

804 Town Blvd NE
Ste 2010
Brookhaven, GA 30319
Phone (404) 631-6277

Practitioners & affiliated clinicians

Practitioners 4

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": "1698278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698278400000",
    "number": "1780456301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 TOWN BLVD NE STE 2010",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303193147",
            "telephone_number": "404-631-6277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 TOWN BLVD NE STE 2010",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303193147",
            "telephone_number": "404-631-6277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN DENTISTRY BROOKHAVEN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-26",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A",
        "authorized_official_last_name": "FRODGE",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-476-0814",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Town Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brookhaven, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.