Organization Active NPI

Village Grove Dental, P.C.

  • General Practice Dentistry
  • Suwanee, GA
National Provider Identifier
1821871732
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
VILLAGE GROVE DENTAL, P.C.
Practice address
4320 Suwanee Dam Rd Ste 1800
Suwanee, GA 30024-1949
Phone
(770) 932-0290
NPI assigned
Aug 15, 2023
Last updated
Aug 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Authorized official

Name
Ben Cutler
Title
Secretary
Phone
(607) 743-9474

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU
Endodontics 1223E0200X NU
General Practice Dentistry 1223G0001X NU Primary
Periodontics 1223P0300X NU
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU

Addresses

Primary practice location

4320 Suwanee Dam Rd Ste 1800
Suwanee, GA 30024-1949

Mailing address

296 S Main St
Alpharetta, GA 30009-1973
Phone (607) 743-9474

National Provider Directory

National Provider Directory

Locations

296 S Main St
Alpharetta, GA 30009
Phone (470) 283-9233

4320 Suwanee Dam Rd
Ste 1800
Suwanee, GA 30024
Phone (770) 932-0290

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692057600000",
    "number": "1821871732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 S MAIN ST",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300091973",
            "telephone_number": "607-743-9474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 SUWANEE DAM RD STE 1800",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241949",
            "telephone_number": "770-932-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE GROVE DENTAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A",
        "authorized_official_last_name": "CUTLER",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "607-743-9474"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • 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.