Pediatric Dentistry for Infants Children & Teens PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

PEDIATRIC DENTISTRY FOR INFANTS CHILDREN & TEENS PC

Practice address

7215 Stonecrest Parkway
Lithonia, GA 30038

Phone

(770) 482-4661

NPI assigned

Apr 10, 2006

Last updated

Jul 10, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wayne R Miller, DMD

Title

Owner

Phone

(770) 482-4661

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1891758991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7215 STONECREST PARKWAY",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "30038",
            "telephone_number": "770-482-4661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7215 STONECREST PARKWAY",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "30038",
            "telephone_number": "770-482-4661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY FOR INFANTS CHILDREN & TEENS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-482-4661",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Lithonia, GA
• Providers in Lithonia, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.