Peachtree Periodontics & Dental Implants

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

009974 Issued in GA

Legal business name

PEACHTREE PERIODONTICS & DENTAL IMPLANTS

Practice address

306 Stevens Entry
Peachtree City, GA 30269-1325

Phone

(770) 487-7734

Fax

(770) 487-1783

NPI assigned

Jan 19, 2007

Last updated

Oct 2, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David Robert Davenport, DMD, MSNPI 1295869345

Title

Doctor

Phone

(770) 487-7734

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, and the practitioner matching its NPPES authorized official.

• David R Davenport, DMD , MS

  • Periodontics
  • Peachtree City, GA
  • NPI 1295869345
  NPD (past) Authorized official

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349136000000",
    "number": "1841343316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 STEVENS ENTRY",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691325",
            "telephone_number": "770-487-7734",
            "fax_number": "770-487-1783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 STEVENS ENTRY",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691325",
            "telephone_number": "770-487-7734",
            "fax_number": "770-487-1783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE PERIODONTICS & DENTAL IMPLANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2012-10-02",
        "status": "A",
        "authorized_official_last_name": "DAVENPORT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "770-487-7734",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "GA",
            "license": "009974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peachtree Medical Center
• Peachtree Medical Supply LLC
• Peachtree Omfs LLC, DBN Peachtree Oral & Facial Surgery
• Peachtree Pediatric Dentistry
• Peachtree Pediatrics PC
• Peachtree Psychotherapy
• Peachtree Senior Care LLC
• Peachtree Total Wellness LLC
• Peachtree Wellness Solutions LLC
• Rebekah Kay Pearson, PT, DPT

• Periodontics in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Periodontics in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; 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.