NPIMap

Organization Active NPI

Ga SDS III PC

Doing business as Elite Smiles Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Atlanta, GA
National Provider Identifier
1861255093
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
GA SDS III PC
Doing business as
Elite Smiles Orthodontics
Practice address
91 W Wieuca Rd NE Ste 300
Atlanta, GA 30342-3248
Phone
(404) 303-7400
NPI assigned
Jan 31, 2024
Last updated
Jan 31, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
GA SDS III PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Authorized official

Name
Charlotte V Dasch
Title
Direc of Cred and Prov Rel
Phone
(504) 638-0303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

91 W Wieuca Rd NE Ste 300
Atlanta, GA 30342-3248

Mailing address

1610 54TH Ave N Ste 205
Nashville, TN 37209-1442

Other names 1

  • Elite Smiles Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ga SDS III PC2 organizations share this tax ID, including this one
Part of
Ga SDS III PC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1706659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1861255093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 54TH AVE N STE 205",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372091442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 W WIEUCA RD NE STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303423248",
            "telephone_number": "404-303-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GA SDS III PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GA SDS III PC",
        "enumeration_date": "2024-01-31",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A",
        "authorized_official_last_name": "DASCH",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "DIREC OF CRED AND PROV REL",
        "authorized_official_telephone_number": "504-638-0303"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Smiles Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.