Proud Smiles LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PROUD SMILES LLC

Practice address

5290 Roswell Rd Ste A130
Atlanta, GA 30342-1978

Phone

(404) 257-0091

NPI assigned

Aug 14, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Radha J Patel, DMDNPI 1376975425

Title

Manager

Phone

(404) 257-0091

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Radha J Patel, DMD

  • Student in an Organized Health Care Education/Training Program
  • Alpharetta, GA
  • NPI 1376975425
  NPD Authorized official

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692057600000",
    "number": "1821771072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5290 ROSWELL RD STE A130",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421978",
            "telephone_number": "404-257-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5290 ROSWELL RD STE A130",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421978",
            "telephone_number": "404-257-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROUD SMILES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-14",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-14",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "RADHA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "404-257-0091",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Atlanta, GA
• Providers in Atlanta, 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 15, 2023; 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.