Villa Rica Family Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN0112559 Issued in GA

Legal business name

VILLA RICA FAMILY DENTAL

Practice address

865 S Carroll Rd Ste C
Villa Rica, GA 30180-7056

Phone

(770) 459-4131

Fax

(770) 459-4132

NPI assigned

Sep 8, 2008

Organization subpart

No

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

Authorized official

Name

Jamey ChangNPI 1902944812

Title

Dentist

Phone

(770) 459-4131

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Jamey S. Chang, DMD

  • General Practice Dentistry
  • Villa Rica, GA
  • NPI 1902944812
  NPD (past) Authorized official
• Stacey Marie McDowell, DMD

  • Dentist
  • Villa Rica, GA
  • NPI 1669902292

  General Practice

  NPD (past)

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220832000000",
    "number": "1780832386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 S CARROLL RD STE C",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301807056",
            "telephone_number": "770-459-4131",
            "fax_number": "770-459-4132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 S CARROLL RD STE C",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301807056",
            "telephone_number": "770-459-4131",
            "fax_number": "770-459-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLA RICA FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-08",
        "last_updated": "2008-09-08",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "JAMEY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "770-459-4131"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN0112559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129648207A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victory Nursing & Home Care, Inc.
• Vidro Industries, LLC
• Vidro Industries, LLC
• Villa Rica Behavioral Health PC
• Villa Rica Dental Smiles LLC
• Villa Rica OB GYN Inc
• Villa Rica RX LLC
• Villa Rica RX LLC
• Richard Brent Wadsworth Jr., LAPC
• Wal-Mart Stores East LP

• General Practice Dentistry in Villa Rica, GA
• Providers in Villa Rica, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; 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.