Senoia Family Dentistry, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN012740 Issued in GA

Legal business name

SENOIA FAMILY DENTISTRY, LLC

Practice address

42 Main St
Suite 3B
Senoia, GA 30276-1889

Phone

(770) 599-4441

Fax

(770) 599-4442

NPI assigned

Nov 19, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Ragan Faler, DMD

Title

Owner

Phone

(678) 289-0382

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maria Walsh

  • General Practice Dentistry
  • Senoia, GA
  • NPI 1871644013
  NPD (past)

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1861736514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 MAIN ST",
            "address_2": "SUITE 3B",
            "city": "SENOIA",
            "state": "GA",
            "postal_code": "302761889",
            "telephone_number": "770-599-4441",
            "fax_number": "770-599-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 MAIN ST",
            "address_2": "SUITE 3B",
            "city": "SENOIA",
            "state": "GA",
            "postal_code": "302761889",
            "telephone_number": "770-599-4441",
            "fax_number": "770-599-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENOIA FAMILY DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-19",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "FALER",
        "authorized_official_first_name": "RAGAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-289-0382",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012740",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "GA",
            "license": "DN012726",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teki Mashawn Russell, OTR/L
• Melissa Gayle Schmidt, PT, MPT
• Emily Greene Schubert, BACB
• Deborah Mischelle Scott, RN, FNP-C
• Senoia Drug Co Inc.
• Sang Ha Shin, MD
• Sisters Tender Care
• Samantha Anni Skurja, LAMFT
• Southern Psychiatric Professionals, LLC
• Southern Psychiatric T.M.S., LLC

• General Practice Dentistry in Senoia, GA
• Providers in Senoia, 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 Nov 19, 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.