Dennis L. Radcliffe, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN011800 Issued in NJ

Practice address

120 N Medical Pkwy
Building 200, Suite 100
Woodstock, GA 30189-7062

Phone

(770) 591-7929

Fax

(770) 591-3365

NPI assigned

Aug 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Towne Lake Family Dentistry, LTD.

  • General Practice Dentistry
  • Woodstock, GA
  • NPI 1629380191
  NPD (past)

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841308202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 BACCURATE DR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300628702",
            "telephone_number": "770-650-8389",
            "fax_number": "770-591-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N MEDICAL PKWY",
            "address_2": "BUILDING 200, SUITE 100",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301897062",
            "telephone_number": "770-591-7929",
            "fax_number": "770-591-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADCLIFFE",
        "first_name": "DENNIS",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DN011800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Quinton, RBT
• Emily Marie Quiza, PT, DPT
• R and M Behavioral Health and Wellness, LLC
• R. S. Hawkins Anesthesiology, LLC
• Robyn Racey-Wehr, M.S., CCC-SLP
• Ruth Radin
• Catherine Wilson Rahaim, LCSW
• Naveen T Raj, D.O
• Julie Taylor Rambo, MS, RD, LD
• Emily J Ramirez, MSW

• General Practice Dentistry in Woodstock, GA
• Providers in Woodstock, 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 Jul 8, 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.