NPIMap

Organization Active NPI

Creative Dentistry of Atlanta

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1801389812
Registry record updated Jun 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN012610 Issued in GA
Legal business name
CREATIVE DENTISTRY OF ATLANTA
Practice address
5505 Peachtree Dunwoody Road
Suite 460
Atlanta, GA 30342
Phone
(404) 883-3287
Fax
(404) 883-3289
NPI assigned
Jun 13, 2018
Last updated
Jun 13, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2018

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

Authorized official

Name
Dr. Anitha R Reddy, DMD
Title
Ceo/Owner
Phone
(404) 883-3287

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN012610 GA Primary

Addresses

Primary practice location

5505 Peachtree Dunwoody Road
Suite 460
Atlanta, GA 30342

Mailing address

5505 Peachtree Dunwoody Road
Suite 460
Atlanta, GA 30342
Phone (404) 883-3287

National Provider Directory

National Provider Directory
Tax ID family
Creative Dentistry of Atlanta2 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.

NPI Registry JSON

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528848000000",
    "number": "1801389812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5505 PEACHTREE DUNWOODY ROAD",
            "address_2": "SUITE 460",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30342",
            "telephone_number": "404-883-3287",
            "fax_number": "404-883-3289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 PEACHTREE DUNWOODY ROAD",
            "address_2": "SUITE 460",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30342",
            "telephone_number": "404-883-3287",
            "fax_number": "404-883-3289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE DENTISTRY OF ATLANTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-13",
        "last_updated": "2018-06-13",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "ANITHA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "404-883-3287",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2018; 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.