NPIMap

Organization Active NPI

Dental Professionals of Georgia, P.C.

  • Dentist
  • Lilburn, GA
National Provider Identifier
1881150498
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DENTAL PROFESSIONALS OF GEORGIA, P.C.
Practice address
645 Beaver Ruin Rd NW Ste a
Lilburn, GA 30047-3471
Phone
(770) 381-9320
NPI assigned
Feb 19, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Authorized official

Name
Brittany Howard
Title
Cred Coordinator
Phone
(217) 540-8946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

645 Beaver Ruin Rd NW Ste a
Lilburn, GA 30047-3471

Mailing address

645 Beaver Ruin Rd NW Ste a
Lilburn, GA 30047-3471
Phone (770) 381-9320

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of Georgia PC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

645 Beaver Ruin Rd NW
Ste A
Lilburn, GA 30047
Phone (770) 381-9320

Ownership & related parties

Subparts reporting this organization as parent 4

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

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": "1550534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550534400000",
    "number": "1881150498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 BEAVER RUIN RD NW STE A",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473471",
            "telephone_number": "770-381-9320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 BEAVER RUIN RD NW STE A",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473471",
            "telephone_number": "770-381-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF GEORGIA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-19",
        "last_updated": "2019-02-19",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "CRED COORDINATOR",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lilburn, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; 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.