Cindy Rask, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN123015 Issued in GA

Practice address

775 S Park St
Carrollton, GA 30117-3812

Phone

(678) 839-0031

NPI assigned

May 13, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bespoke Dental LLC

  • Dental Clinic/Center
  • Newnan, GA
  • NPI 1326897802
  NPD Authorized official

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1831755156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 SPRINGDALE DR",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302402654",
            "telephone_number": "786-210-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 S PARK ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173812",
            "telephone_number": "678-839-0031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7651 S Main St",
            "address_purpose": "LOCATION",
            "city": "Midvale",
            "state": "UT",
            "postal_code": "840477101",
            "country_code": "US",
            "telephone_number": "801-417-0131",
            "fax_number": "801-255-5814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RASK",
        "first_name": "CINDY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-13",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "11262202-9921",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN123015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Carrollton, GA
• Providers in Carrollton, 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 Mar 13, 2024; 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.