Mouthpeace Dental LLC

Primary specialty

DentistTaxonomy code 122300000X

License

DN013505 Issued in GA

Legal business name

MOUTHPEACE DENTAL LLC

Practice address

1050 Marietta St NW
Suite a
Atlanta, GA 30318-5522

Phone

(312) 371-1423

NPI assigned

Nov 7, 2014

Organization subpart

Yes

Parent organization

MOUTHPEACE DENTAL LLCAs reported in NPPES

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

Authorized official

Name

Syretta Wells, DDS

Title

Dentist

Phone

(312) 371-1423

Specialties & licenses 3

Addresses

Part of

Mouthpeace Dental LLC

Locations

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

{
    "created_epoch": "1415318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415318400000",
    "number": "1942606645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 MARIETTA ST NW",
            "address_2": "SUITE A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303185522",
            "telephone_number": "312-371-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 MARIETTA ST NW",
            "address_2": "SUITE A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303185522",
            "telephone_number": "312-371-1423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUTHPEACE DENTAL LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOUTHPEACE DENTAL LLC",
        "enumeration_date": "2014-11-07",
        "last_updated": "2014-11-07",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "SYRETTA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "312-371-1423",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN013505",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013505",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "GA",
            "license": "DN013505",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Helen Nour Mourra
• Claire Marie Mouser, PHD, RD
• Asma Moussaoui, M.D
• Mahamed Mousse
• Mouthpeace Dental 2, PC
• Rodrica Lashae Mouton
• Felicia Moutry, L.P.C
• Sara Selina Mouzi-Escobedo, D.D.S.
• Richard R. Mouzon, PHD
• Mov2Liv Foundation Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2014; 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.