NPIMap

Organization Active NPI

Wranglehurst, P.C.

  • Periodontics
  • Norcross, GA
National Provider Identifier
1790196467
Registry record updated May 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DN0010757 Issued in GA
Legal business name
WRANGLEHURST, P.C.
Practice address
3850 Holcomb BR. Rd
Suite 230
Norcross, GA 30092
Phone
(770) 447-5311
Fax
(770) 447-1865
NPI assigned
May 15, 2014
Last updated
May 15, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2014

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

Authorized official

Name
Dr. Page Phelps Barden, D.D.S., M.S.DNPI 1932115102
Title
Pres/Ceo
Phone
(404) 272-2512

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
Periodontics 1223P0300X DN0010757 GA Primary

Addresses

Primary practice location

3850 Holcomb BR. Rd
Suite 230
Norcross, GA 30092

Mailing address

4947 Fairhaven Way NE
Roswell, GA 30075
Phone (404) 272-2512

Other identifiers 1

IdentifierTypeStateIssuer
00882934DMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Wranglehurst PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1400112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400112000000",
    "number": "1790196467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4947 FAIRHAVEN WAY NE",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "30075",
            "telephone_number": "404-272-2512",
            "fax_number": "404-601-9762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 HOLCOMB BR. RD",
            "address_2": "SUITE 230",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "30092",
            "telephone_number": "770-447-5311",
            "fax_number": "770-447-1865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WRANGLEHURST, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-15",
        "last_updated": "2014-05-15",
        "status": "A",
        "authorized_official_last_name": "BARDEN",
        "authorized_official_first_name": "PAGE",
        "authorized_official_middle_name": "PHELPS",
        "authorized_official_title_or_position": "PRES/CEO",
        "authorized_official_telephone_number": "404-272-2512",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.S.D"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "GA",
            "license": "DN0010757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00882934D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2014; 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.