Hickory Flat Orthodontics, PC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

HICKORY FLAT ORTHODONTICS, PC

Practice address

6488 Hickory Flat Hwy
Canton, GA 30115-7235

Phone

(770) 720-8138

Fax

(770) 720-7580

NPI assigned

Apr 24, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Carl M. Russell, DMD, PHDNPI 1902873276

Title

President

Phone

(770) 720-8138

Specialties & licenses 1

Addresses

Locations

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carl M. Russell, DMD, PHD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Canton, GA
  • NPI 1902873276

  Orthodontics and Dentofacial Orthopedics

  NPD (past) Authorized official
• Kameron Tauber, DDS MS

  • Pediatric Dentistry
  • Canton, GA
  • NPI 1699471268
  NPD (past)

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952520751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6488 HICKORY FLAT HWY",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301157235",
            "telephone_number": "770-720-8138",
            "fax_number": "770-720-7580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6488 HICKORY FLAT HWY",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301157235",
            "telephone_number": "770-720-8138",
            "fax_number": "770-720-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HICKORY FLAT ORTHODONTICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-720-8138",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, PHD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Lynn Hernandez, M.D.
• Ernesto E Hernandez, MD
• Jamie Hiam
• Kimberle J Hickey, CRNA
• Hickory Drugs
• Joel Edward Higgins, MD
• Highland Rivers Community Service Board
• Highland Rivers Community Service Board
• Highland Rivers CSB
• Highland Rivers CSB

• All providers in Canton, GA
• Orthodontics and Dentofacial Orthopedics Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.