Oak Grove Pediatric Dentistry, P.C.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

OAK GROVE PEDIATRIC DENTISTRY, P.C.

Practice address

3744 Lavista Rd
Decatur, GA 30033-1045

Phone

(770) 934-3506

NPI assigned

Aug 15, 2023

Organization subpart

No

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

Authorized official

Name

Ben Cutler

Title

Secretary

Phone

(607) 743-9474

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692057600000",
    "number": "1942083852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 S MAIN ST STE 300",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300091973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3744 LAVISTA RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300331045",
            "telephone_number": "770-934-3506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK GROVE PEDIATRIC DENTISTRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A",
        "authorized_official_last_name": "CUTLER",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "607-743-9474"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria O'Farrell, OTR/L
• Katherine O'Lone, LCSW
• Lynn Bunch O'Neill, M.D.
• Jesse Garrett O'Shea, M.D., MSC
• Timothy J O'Shea, D.D.S.
• Oakhurst Occupational Therapy
• Oakhurst Pediatrics, LLC
• Meredith Ann Oakley, DVM
• Oasis Family Care
• OB GYN Women Specialist of Ga

• Pediatric Dentistry in Decatur, GA
• Providers in Decatur, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.