Monroe Family & Cosmetic Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MONROE FAMILY & COSMETIC DENTISTRY

Practice address

2120 W Spring St Ste 1100
Monroe, GA 30655-3900

Phone

(770) 266-7188

Fax

(770) 266-7159

NPI assigned

Feb 2, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Pavel Tsur-Tsar, D.D.S.

Title

Owner

Phone

(770) 266-7188

Specialties & licenses 4

Addresses

Practitioners 1

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

• Olexa Podebryi, DDS

  • Dentist
  • Monroe, GA
  • NPI 1871808378

  General Practice

  NPD (past)

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454371200000",
    "number": "1902264252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 W SPRING ST STE 1100",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306553900",
            "telephone_number": "770-266-7188",
            "fax_number": "770-266-7159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 W SPRING ST STE 1100",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306553900",
            "telephone_number": "770-266-7188",
            "fax_number": "770-266-7159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONROE FAMILY & COSMETIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-02",
        "last_updated": "2016-02-02",
        "status": "A",
        "authorized_official_last_name": "TSUR-TSAR",
        "authorized_official_first_name": "PAVEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-266-7188",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dental Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aundre R. Mitchell, FNP-BC
• Mary Grace Mitchell, MSW
• Dylan Keith Mixson, FNP-C
• Amar Mohan, MD
• Monroe Drug Company
• Monroe Family and Cosmetic Dentistry
• Monroe Hma Inc (Walton Regional Medical Center)
• Monroe Hma LLC (Walton Regional Nursing Home)
• Monroe Hma LLC (Clearview Regional Medical Center)
• Monroe Hma Physician Management LLC

• General Practice Dentistry in Monroe, GA
• Providers in Monroe, 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 Feb 2, 2016; 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.