NPIMap

Organization Active NPI

Children'S Dental Center, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Cartersville, GA
National Provider Identifier
1871963447
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
CHILDREN'S DENTAL CENTER, PC
Doing business as
Children's Dental Center, PC:Sedation and Oral Surgery
Practice address
1010 N Tennessee St
Ste 105
Cartersville, GA 30120-8525
Phone
(770) 672-7481
Fax
(770) 382-1915
NPI assigned
Sep 25, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Authorized official

Name
Jennifer A Cline
Title
Credentialing Specialist
Phone
(770) 672-7481

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

1010 N Tennessee St
Ste 105
Cartersville, GA 30120-8525

Mailing address

1010 N Tennessee St
Ste 105
Cartersville, GA 30120-8525
Phone (770) 672-7481

Other names 1

  • Children's Dental Center, PC:Sedation and Oral Surgery Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Children'S Dental Center PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1010 N Tennessee St
Ste 105
Cartersville, GA 30120
Phone (706) 749-4900

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1443139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696809600000",
    "number": "1871963447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N TENNESSEE ST",
            "address_2": "STE 105",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301208525",
            "telephone_number": "770-672-7481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N TENNESSEE ST",
            "address_2": "STE 105",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301208525",
            "telephone_number": "770-672-7481",
            "fax_number": "770-382-1915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S DENTAL CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-25",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A",
        "authorized_official_last_name": "CLINE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "770-672-7481"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Dental Center, PC:Sedation and Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Children's Dental Center, PC:Sedation and Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cartersville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; 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.