The Children'S Dental Group, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN012631 Issued in GA

Legal business name

THE CHILDREN'S DENTAL GROUP, LLC

Practice address

560 Thornton Rd
Suite 203
Lithia Springs, GA 30122-1655

Phone

(770) 234-4859

NPI assigned

Feb 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Ida Lynn Rose-Mize, DDS

Title

Pediatric Dentist

Phone

(770) 941-8802

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1170460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851439459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 THORNTON RD",
            "address_2": "SUITE 203",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301221655",
            "telephone_number": "770-234-4859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 THORNTON RD",
            "address_2": "SUITE 203",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301221655",
            "telephone_number": "770-234-4859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHILDREN'S DENTAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROSE-MIZE",
        "authorized_official_first_name": "IDA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "770-941-8802",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN012631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Praise Tarver, BCBA
• Taylor Healing Institute
• Tekay Enterprise
• Terell Tepper
• Reeves Terris, A-GNP
• The Kroger Co
• The Neuropsychiatric Clinic of Atlantis-Villa Rica, P.C.
• The Speech and Language Therapy Center, LLC
• Anne Thiongo
• Nacole Thompson

• Pediatric Dentistry in Lithia Springs, GA
• Providers in Lithia Springs, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.