NPIMap

Organization Active NPI

East Atlanta Dental

  • Dental Clinic/Center
  • Decatur, GA
National Provider Identifier
1891426367
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
EAST ATLANTA DENTAL
Practice address
5040 Snapfinger Woods Dr Ste 203
Decatur, GA 30035-4020
Phone
(770) 981-9700
Fax
(770) 323-6226
NPI assigned
Jun 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Authorized official

Name
Jessica Lee, OWNERNPI 1043528193
Title
Owner
Phone
(770) 981-9700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

5040 Snapfinger Woods Dr Ste 203
Decatur, GA 30035-4020

Mailing address

5040 Snapfinger Woods Dr Ste 203
Decatur, GA 30035-4020
Phone (770) 981-9700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address admin@eastatldental.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

5040 Snapfinger Woods Dr
Ste 203
Decatur, GA 30035
Phone (770) 821-9200

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": "1655942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655942400000",
    "number": "1891426367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5040 SNAPFINGER WOODS DR STE 203",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300354020",
            "telephone_number": "770-981-9700",
            "fax_number": "770-323-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5040 SNAPFINGER WOODS DR STE 203",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300354020",
            "telephone_number": "770-981-9700",
            "fax_number": "770-323-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST ATLANTA DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-981-9700",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@eastatldental.com",
            "affiliation": "N",
            "endpointDescription": "DENTIST OFFICE",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5040 Snapfinger Woods Dr Ste 203",
            "city": "Decatur",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300354020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.