Prasanthi Pattabhi

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN122307 Issued in GA

Practice address

1165 Lawrenceville Suwanee Rd Ste C
Lawrenceville, GA 30043-8741

Phone

(470) 582-9678

NPI assigned

Jul 14, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Affordable Family Dentistry PC

  • General Practice Dentistry
  • Lawrenceville, GA
  • NPI 1861184210
  NPD Authorized official

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1942818182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 LAWRENCEVILLE SUWANEE RD STE C",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300438741",
            "telephone_number": "470-582-9678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 LAWRENCEVILLE SUWANEE RD STE C",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300438741",
            "telephone_number": "470-582-9678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTABHI",
        "first_name": "PRASANTHI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-14",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "9696",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN122307",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.032725",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Paterson, DMD
• Kush Nigam Pathak, DO
• Sandeep V Pathak, DMD, MD
• Patients 'R' US
• Lauren Brooke Patrick, OTR/L
• Paul A Pattacini, PAAA
• Delores Jean Patterson, LMSW
• Natasha M Patterson, LPC, NCC
• Samuel Patterson
• Shantia L Patterson

• General Practice Dentistry in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.