NPIMap

Organization Active NPI

Childrens Dentistry at Stonecrest

  • Pediatric Dentistry
  • Lithonia, GA
National Provider Identifier
1790046464
Registry record updated Mar 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN012294 Issued in GA
Legal business name
CHILDRENS DENTISTRY AT STONECREST
Practice address
8180 Mall Pkwy
810
Lithonia, GA 30038-6911
Phone
(770) 484-4994
Fax
(770) 484-4575
NPI assigned
May 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2013

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

Authorized official

Name
Dr. Sonya Lynette Windham, DMDNPI 1871695056
Title
Owner/Operator
Phone
(770) 484-4994

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
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X DN012294 GA Primary

Addresses

Primary practice location

8180 Mall Pkwy
810
Lithonia, GA 30038-6911

Mailing address

8180 Mall Pkwy
810
Lithonia, GA 30038-6911
Phone (770) 484-4994

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, 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": "1338336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362096000000",
    "number": "1790046464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8180 MALL PKWY",
            "address_2": "810",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300386911",
            "telephone_number": "770-484-4994",
            "fax_number": "770-484-4575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8180 MALL PKWY",
            "address_2": "810",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300386911",
            "telephone_number": "770-484-4994",
            "fax_number": "770-484-4575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS DENTISTRY AT STONECREST",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-30",
        "last_updated": "2013-03-01",
        "status": "A",
        "authorized_official_last_name": "WINDHAM",
        "authorized_official_first_name": "SONYA",
        "authorized_official_middle_name": "LYNETTE",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "770-484-4994",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN012294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithonia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2013; 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.