NPIMap

Organization Active NPI

CCSD-Dacula, LLC

  • Dental Clinic/Center
  • Dacula, GA
National Provider Identifier
1932754223
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
CCSD-DACULA, LLC
Doing business as
Center for Cosmetic and Sedation Dentistry, LLC
Practice address
420 Dacula Rd
Dacula, GA 30019-2128
Phone
(770) 277-0800
NPI assigned
Aug 5, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Rachel Smallwood
Title
Office Manager
Phone
(770) 995-1957

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

420 Dacula Rd
Dacula, GA 30019-2128

Mailing address

420 Dacula Rd
Dacula, GA 30019-2128
Phone (770) 277-0800

Other names 1

  • Center for Cosmetic and Sedation Dentistry, LLC Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL info@centerforsedation.com Direct Center For Cosmetic And Sedation Dentistry

National Provider Directory

National Provider Directory

Locations

420 Dacula Rd
Dacula, GA 30019
Phone (770) 277-0800

1030 Duluth Hwy
Lawrenceville, GA 30043
Phone (770) 995-1957

Practitioners & affiliated clinicians

Practitioners 6

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": "1564963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1932754223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DACULA RD",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300192128",
            "telephone_number": "770-277-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 DACULA RD",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300192128",
            "telephone_number": "770-277-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCSD-DACULA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-05",
        "last_updated": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "SMALLWOOD",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-995-1957"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "info@centerforsedation.com",
            "affiliation": "Y",
            "endpointDescription": "Office Location",
            "affiliationName": "Center For Cosmetic And Sedation Dentistry",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1030 Duluth Hwy",
            "city": "Lawrenceville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300435215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Center for Cosmetic and Sedation Dentistry, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dacula, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.