Ivy Dentistry LLC

Primary specialty

DentistTaxonomy code 122300000X

License

DN011829 Issued in GA

Legal business name

IVY DENTISTRY LLC

Practice address

11775 Northfall LN
Alpharetta, GA 30004-7978

Phone

(770) 619-2909

Fax

(770) 619-2939

NPI assigned

Feb 27, 2007

Last updated

Dec 21, 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. Erin Bang, DDS

Title

Dentist

Phone

(770) 619-2909

Specialties & licenses 1

Addresses

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.

• Erin Bang-Crooks, DDS

  • Dentist
  • Alpharetta, GA
  • NPI 1417084641
  NPD (past)

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198195200000",
    "number": "1811024078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80097",
            "city": "CHAMBLEE",
            "state": "GA",
            "postal_code": "303660097",
            "telephone_number": "770-619-2909",
            "fax_number": "770-619-2939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11775 NORTHFALL LN",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300047978",
            "telephone_number": "770-619-2909",
            "fax_number": "770-619-2939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-12-21",
        "status": "A",
        "authorized_official_last_name": "BANG",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "770-619-2909",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN011829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.