Psa DDS LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PSA DDS LLC

Practice address

2655 Dallas Hwy SW Ste 530
Marietta, GA 30064-7520

Phone

(770) 422-8776

NPI assigned

Jul 12, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Sanil Patel, DDSNPI 1487919536

Title

Owner

Phone

(770) 422-8776

Specialties & licenses 1

Addresses

Other names 1

• PURE SMILES DENTISTRY Doing business as

Locations

Practitioners 1

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

• Sanil Patel, D.D.S

  • Dentist
  • Marietta, GA
  • NPI 1487919536
  NPD Authorized official

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

{
    "created_epoch": "1720742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720742400000",
    "number": "1912744285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 DALLAS HWY SW STE 530",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300647520",
            "telephone_number": "770-422-8776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 DALLAS HWY SW STE 530",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300647520",
            "telephone_number": "770-422-8776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSA DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-12",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "SANIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-422-8776",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PURE SMILES DENTISTRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lashanti Melba Pruitt, MA
• Pruitthealth - Marietta, LLC
• Pruittplace - East Cobb, LLC
• Mariah Christine Pryor, AAC
• PS DDS
• Psalm 121 Hair Studio
• Psych Atlanta, P.C.
• Psychiatric Health Professionals, P.C.
• Psychological Affiliates
• Psychological Consultants of Marietta, PC

• Dentist in Marietta, GA
• Providers in Marietta, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.