Jason M. Campbell DDS Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN012764 Issued in GA

Legal business name

JASON M. CAMPBELL DDS INC.

Doing business as

Gwinnett Place Dental

Practice address

2100 Pleasant Hill Rd
Suite 366
Duluth, GA 30096-4701

Phone

(770) 476-4140

NPI assigned

Aug 22, 2007

Last updated

Aug 22, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jason Michael Campbell, D.D.S.

Title

Owner

Phone

(770) 476-4140

Specialties & licenses 1

Addresses

Other names 1

• Gwinnett Place Dental Doing business as

Locations

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187740800000",
    "number": "1790978849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 PLEASANT HILL RD",
            "address_2": "SUITE 366",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964701",
            "telephone_number": "770-476-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 PLEASANT HILL RD",
            "address_2": "SUITE 366",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964701",
            "telephone_number": "770-476-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON M. CAMPBELL DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-22",
        "last_updated": "2007-08-22",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-476-4140",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gwinnett Place Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Duluth, GA
• Providers in Duluth, 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 Aug 22, 2007; 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.