Periodontics & Dental Implants, LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

011840 Issued in GA

Legal business name

PERIODONTICS & DENTAL IMPLANTS, LLC

Practice address

163 Jefferson Pkwy
Newnan, GA 30263-5823

Phone

(770) 254-0401

Fax

(770) 254-8483

NPI assigned

Jan 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John Harvey

Title

Owner

Phone

(770) 254-0401

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417996800000",
    "number": "1811045818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 JEFFERSON PKWY",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302635823",
            "telephone_number": "770-254-0401",
            "fax_number": "770-254-8483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 JEFFERSON PKWY",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302635823",
            "telephone_number": "770-254-0401",
            "fax_number": "770-254-8483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIODONTICS & DENTAL IMPLANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2014-12-08",
        "status": "A",
        "authorized_official_last_name": "HARVEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-254-0401",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "GA",
            "license": "011840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Dentistry of Newnan, LLC
• Tia Chalise Penn-Tabor
• Gianna Rose Penton-Depretoro
• Harry Jacobi Peoples II, DMD
• Chelsea Clark Pepples, PHARMD
• Connie Perkins, OT/L
• Perry Street Dental, P.C.
• Latonia Person, RBT
• Willnella Patray Peters, O.D.
• Christa Petrivelli, RBT

• Periodontics in Newnan, GA
• Providers in Newnan, GA by specialty
• Periodontics in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.