Active NPI
MH Dental P.C.
Doing business as Vital Smiles Georgia
- General Practice Dentistry
- Albany, GA
National Provider Identifier
1801941950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- MH DENTAL P.C.
- Doing business as
- Vital Smiles Georgia
- Practice address
- 1030A West Gordon Ave
Albany, GA 31701 - Phone
- (229) 432-9555
- Fax
- (229) 432-0907
- NPI assigned
- Jan 25, 2007
- Last updated
- Jul 24, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Crystal G. Walker
- Title
- Collections Manager
- Phone
- (205) 271-6851
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | GA | Primary |
Addresses
Primary practice location
1030A West Gordon Ave
Albany, GA 31701
Mailing address
1030A West Gordon Ave
Albany, GA 31701
Phone (229) 432-9555
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 112036 | Medicaid | GA | |
| 714338776A | Medicaid | GA | |
| 1892015 | Other | GA | UNITED CONCORDIA |
| 200075582 | Other | GA | BCBS |
| 39888 | Medicaid | GA |
Other names 1
- Vital Smiles Georgia
National Provider Directory
National Provider Directory- Tax ID family
- MH Dental PC
Other organizations with this tax ID 2
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": "1169683200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1343088000000",
"number": "1801941950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1030A WEST GORDON AVE",
"city": "ALBANY",
"state": "GA",
"postal_code": "31701",
"telephone_number": "229-432-9555",
"fax_number": "229-432-0907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030A WEST GORDON AVE",
"city": "ALBANY",
"state": "GA",
"postal_code": "31701",
"telephone_number": "229-432-9555",
"fax_number": "229-432-0907"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MH DENTAL P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-25",
"last_updated": "2012-07-24",
"status": "A",
"authorized_official_last_name": "WALKER",
"authorized_official_first_name": "CRYSTAL",
"authorized_official_middle_name": "G.",
"authorized_official_title_or_position": "COLLECTIONS MANAGER",
"authorized_official_telephone_number": "205-271-6851"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "GA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "112036",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "714338776A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "1892015",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "200075582",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39888",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Vital Smiles Georgia",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Albany, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.