Cordaryl Lee Whitehead

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN124310 Issued in GA

Practice address

42 Market Square Rd
Newnan, GA 30265-5613

Phone

(470) 837-5258

NPI assigned

Jul 11, 2023

Last updated

Aug 11, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Comfortable Care Dental Health Professionals, P.a.

  dba Dental Care on Yellow Bluff

  • General Practice Dentistry
  • Jacksonville, FL
  • NPI 1194474445
  NPD

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

{
    "created_epoch": "1689033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1952089609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13072 BUCK RIDGE LN",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302911181",
            "telephone_number": "205-496-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 MARKET SQUARE RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302655613",
            "telephone_number": "470-837-5258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "CORDARYL",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-11",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN28351",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN124310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittny K White, CNM
• Christopher Blake White, PT, DPT, ATC
• Emma Grace Hess White
• Sharon Mathews White, CRNA
• Tylor White, RBT
• Adalias Whitfield, RBT
• Darren Whitfield, LPC
• Kalee Whitley, DMD
• Kimberly Patrice Whitner, LPC
• William J Whittington, CRNA

• General Practice Dentistry in Newnan, GA
• Providers in Newnan, 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 Aug 11, 2026; 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.