Local Dental Partners, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DN013645 Issued in GA

Legal business name

LOCAL DENTAL PARTNERS, LLC

Doing business as

Walton Center for Family Dentistry

Practice address

4353 Atlanta Highway Suite. 300
Loganville, GA 30052

Phone

(770) 405-2030

NPI assigned

Jun 2, 2017

Organization subpart

Yes

Parent organization

LOCAL DENTAL PARTNERS, LLCAs reported in NPPES

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

Authorized official

Name

Ashley Nichelle Thomas

Title

Credentialing Administrator

Phone

(770) 450-2030

Specialties & licenses 1

Addresses

Other names 1

• Walton Center for Family Dentistry Doing business as

Part of

Local Dental Partners LLC

Locations

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

{
    "created_epoch": "1496361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499990400000",
    "number": "1942738901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4353 ATLANTA HWY STE 300",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300523232",
            "telephone_number": "770-405-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4353 ATLANTA HIGHWAY SUITE. 300",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "30052",
            "telephone_number": "770-405-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOCAL DENTAL PARTNERS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOCAL DENTAL PARTNERS, LLC",
        "enumeration_date": "2017-06-02",
        "last_updated": "2017-07-14",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "NICHELLE",
        "authorized_official_title_or_position": "CREDENTIALING ADMINISTRATOR",
        "authorized_official_telephone_number": "770-450-2030"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "GA",
            "license": "DN013645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walton Center for Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Avadawn Lindsay, PHD, LPC, CPCS
• Maria Renee Lindsey, SLP
• Lisa L. Gentry Speech, Inc.
• Listening Hands Care Services, LLC
• Kimberly Harrell Littrell, APRN
• Cheryl Lockett, PHD
• Loganville Community Ministry Village, Inc.
• Loganville Dental Associates
• Loganville Dentist Office, PC (Loganville Dentist Office)
• Loganville Eyecare, PC

• Dental Clinic/Center in Loganville, GA
• Providers in Loganville, GA by specialty
• Dental Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.