NPIMap

Organization Active NPI

Chastain Park Dentistry, PC

  • General Practice Dentistry
  • Sandy Springs, GA
National Provider Identifier
1902266638
Registry record updated Feb 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CHASTAIN PARK DENTISTRY, PC
Practice address
4600 Roswell Rd
Suite C120
Sandy Springs, GA 30342-3075
Phone
(404) 341-9593
Fax
(404) 418-4543
NPI assigned
Feb 23, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2016

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

Authorized official

Name
Dr. Katie L McCann, DDS
Title
Owner
Phone
(404) 341-9593

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

4600 Roswell Rd
Suite C120
Sandy Springs, GA 30342-3075

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8890

Other names 1

  • Chastain Park Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

4600 Roswell Rd
Unit C120
Sandy Springs, GA 30342
Phone (404) 341-9593

Practitioners & affiliated clinicians

Practitioners 7

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": "1456185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456185600000",
    "number": "1902266638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 ROSWELL RD",
            "address_2": "SUITE C120",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303423075",
            "telephone_number": "404-341-9593",
            "fax_number": "404-418-4543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHASTAIN PARK DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-23",
        "last_updated": "2016-02-23",
        "status": "A",
        "authorized_official_last_name": "MCCANN",
        "authorized_official_first_name": "KATIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-341-9593",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chastain Park Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sandy Springs, GA

Sources for this page

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