West Georgia Dentistry for Children

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

06110450 Issued in GA

Legal business name

WEST GEORGIA DENTISTRY FOR CHILDREN

Practice address

3827 Jimmy Lee Smith Pkwy
Suite 121
Hiram, GA 30141-2804

Phone

(678) 384-1787

Fax

(678) 384-1459

NPI assigned

Mar 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. Sharon Bingham-Shultz, D.M.D.

Title

Dentist

Phone

(678) 384-1787

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332115200000",
    "number": "1861767253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3827 JIMMY LEE SMITH PKWY",
            "address_2": "SUITE 121",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412804",
            "telephone_number": "678-384-1787",
            "fax_number": "678-384-1459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3827 JIMMY LEE SMITH PKWY",
            "address_2": "SUITE 121",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412804",
            "telephone_number": "678-384-1787",
            "fax_number": "678-384-1459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST GEORGIA DENTISTRY FOR CHILDREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-19",
        "last_updated": "2012-03-19",
        "status": "A",
        "authorized_official_last_name": "BINGHAM-SHULTZ",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "678-384-1787",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "06110450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156788755",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wellstar Medical Group, LLC
• Wellstar Paulding Medical Center, Inc.
• Wellstar Paulding Surgical Associates, LLC
• Wellstreet of Georgia PC
• West Ga Family Medicine, PC
• West Georgia Wellness Center LLC
• Brittany McCauley West
• Wgis, Inc.
• Timothy James Whailen, LCSW
• Baley M White, DC

• General Practice Dentistry in Hiram, GA
• Providers in Hiram, 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 Mar 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.