NPIMap

Organization Active NPI

West Cobb Dental Group

  • General Practice Dentistry
  • Marietta, GA
National Provider Identifier
1780719765
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10722 Issued in GA
Legal business name
WEST COBB DENTAL GROUP
Practice address
1001 Whitlock Ave SW
Suite a
Marietta, GA 30064-1930
Phone
(770) 428-5959
Fax
(770) 421-2168
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Rochelle Reynolds, RDH
Title
Business Manager
Phone
(770) 428-5959

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 10722 GA Primary

Addresses

Primary practice location

1001 Whitlock Ave SW
Suite a
Marietta, GA 30064-1930

Mailing address

1001 Whitlock Ave SW
Suite a
Marietta, GA 30064-1930
Phone (770) 428-5959

Other identifiers 1

IdentifierTypeStateIssuer
440414OtherGAUNITED CONCORDIA

Other names 1

  • West Cobb Dental Designs Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780719765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 WHITLOCK AVE SW",
            "address_2": "SUITE A",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300641930",
            "telephone_number": "770-428-5959",
            "fax_number": "770-421-2168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 WHITLOCK AVE SW",
            "address_2": "SUITE A",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300641930",
            "telephone_number": "770-428-5959",
            "fax_number": "770-421-2168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COBB DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "ROCHELLE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "770-428-5959",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "10722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "440414",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Cobb Dental Designs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.