PKR Dental LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PKR DENTAL LLC

Doing business as

Aspen Dental

Practice address

1450 Highway 138 SE
Conyers, GA 30013-1285

Phone

(770) 285-2270

Fax

(770) 761-6301

NPI assigned

Jan 14, 2016

Last updated

Jan 14, 2016By 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

Jennifer La Duc

Title

Provider Relations

Phone

(315) 454-6000

Specialties & licenses 1

Addresses

Other names 1

• Aspen Dental Doing business as

Locations

Practitioners 2

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.

• Shami Gokhale

  • General Practice Dentistry
  • Loganville, GA
  • NPI 1629702899
  NPD (past)
• Alexis Delon Irby, DMD

  • General Practice Dentistry
  • Conyers, GA
  • NPI 1124540224
  NPD (past)

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452729600000",
    "number": "1841656246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189",
            "telephone_number": "315-454-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 HIGHWAY 138 SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300131285",
            "telephone_number": "770-285-2270",
            "fax_number": "770-761-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PKR DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-14",
        "last_updated": "2016-01-14",
        "status": "A",
        "authorized_official_last_name": "LA DUC",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PROVIDER RELATIONS",
        "authorized_official_telephone_number": "315-454-6000"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aspen Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura Renee Pinkney, NP-C
• Pinnacle Autism Services LLC
• Joanne H Piratzky, M.D.
• Stephanie R Pittman, CNM
• Taiti Harden Pitts, LCSW
• Platinum Wellness Retreat & Spa
• Pleasant Peds Care of Conyers LLC
• Shyronda Yvette Pleasant, M.D.
• PM3 Homecare Solutions LLC
• PM3 Outsourcing Solutions, LLC (PM3 Homecare Solutions)

• Dentist in Conyers, GA
• Providers in Conyers, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2016; 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.