NPIMap

Organization Active NPI

Southern Dental Snellville, PC

  • Dentist
  • Snellville, GA
National Provider Identifier
1902338825
Registry record updated Mar 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN014512 Issued in GA
Legal business name
SOUTHERN DENTAL SNELLVILLE, PC
Practice address
1550 Janmar Rd
Suite a
Snellville, GA 30078
Phone
(404) 429-5371
NPI assigned
Mar 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2017

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

Authorized official

Name
Dr. Krishna Patel, DMDNPI 1780931295
Title
Dentist
Phone
(404) 429-5371

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DN014512 GA Primary
Customized Equipment (DME) 332BC3200X DN014512 GA

Addresses

Primary practice location

1550 Janmar Rd
Suite a
Snellville, GA 30078

Mailing address

225 Eagles Landing Way
McDonough, GA 30253-4221

National Provider Directory

National Provider Directory

Locations

1550 Janmar Rd
Ste A
Snellville, GA 30078
Phone (404) 429-5371

Practitioners & affiliated clinicians

Practitioners 1

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": "1490832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490832000000",
    "number": "1902338825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 EAGLES LANDING WAY",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 JANMAR RD",
            "address_2": "SUITE A",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "30078",
            "telephone_number": "404-429-5371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN DENTAL SNELLVILLE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-30",
        "last_updated": "2017-03-30",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "KRISHNA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "404-429-5371",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN014512",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "GA",
            "license": "DN014512",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; 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.