NPIMap

Organization Active NPI

Covington Family Dentistry LLC

  • Dentist
  • Covington, GA
National Provider Identifier
1861738973
Registry record updated Dec 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10491 Issued in GA
Legal business name
COVINGTON FAMILY DENTISTRY LLC
Practice address
4168 Baker St NE
Covington, GA 30014-1404
Phone
(770) 787-2230
NPI assigned
Dec 17, 2012
Last updated
Dec 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2012

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

Authorized official

Name
Dr. John Raymond Hendricks Jr., DDS
Title
Owner
Phone
(404) 375-7326

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10491 GA Primary

Addresses

Primary practice location

4168 Baker St NE
Covington, GA 30014-1404

Mailing address

4168 Baker St NE
Covington, GA 30014-1404
Phone (770) 787-2230

National Provider Directory

National Provider Directory

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": "1355702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355702400000",
    "number": "1861738973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4168 BAKER ST NE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300141404",
            "telephone_number": "770-787-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4168 BAKER ST NE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300141404",
            "telephone_number": "770-787-2230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVINGTON FAMILY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-17",
        "last_updated": "2012-12-17",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-375-7326",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "10491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.