Professional Dental Alliance of Lithonia, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PROFESSIONAL DENTAL ALLIANCE OF LITHONIA, LLC

Practice address

8028 Rockbridge Rd
Lithonia, GA 30058-5882

Phone

(770) 482-2310

NPI assigned

May 23, 2019

Organization subpart

No

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

Authorized official

Name

Jessica Barrette

Title

Credentialing Specialist

Phone

(724) 698-2997

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Cheryl McMahon-Lee, DDS

  • General Practice Dentistry
  • Lithonia, GA
  • NPI 1881744183
  NPD (past)

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558569600000",
    "number": "1891352043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 S MILL ST STE 200",
            "city": "NEW CASTLE",
            "state": "PA",
            "postal_code": "161013680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8028 ROCKBRIDGE RD",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300585882",
            "telephone_number": "770-482-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL ALLIANCE OF LITHONIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-23",
        "last_updated": "2019-05-23",
        "status": "A",
        "authorized_official_last_name": "BARRETTE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "724-698-2997"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Lithonia, GA
• Providers in Lithonia, 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 May 23, 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.