NPIMap

Organization Active NPI

Children and Teen Dental Group

  • General Practice Dentistry
  • Dacula, GA
National Provider Identifier
1952764797
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CHILDREN AND TEEN DENTAL GROUP
Practice address
2119 Hamilton Creek Pkwy Ste 200
Dacula, GA 30019-3293
Phone
(770) 744-4581
NPI assigned
Mar 30, 2016
Last updated
Sep 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Authorized official

Name
Jennifer Jordan Rogers
Title
Credentialing Specialist
Phone
(470) 801-4637

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X

Addresses

Primary practice location

2119 Hamilton Creek Pkwy Ste 200
Dacula, GA 30019-3293

Mailing address

2300 Lakeview Pkwy Ste 250
Alpharetta, GA 30009-3954
Phone (470) 750-4866

National Provider Directory

National Provider Directory
Tax ID family
Children and Teen Dental Group8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788912000000",
    "number": "1952764797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 LAKEVIEW PKWY STE 250",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300093954",
            "telephone_number": "470-750-4866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2119 HAMILTON CREEK PKWY STE 200",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300193293",
            "telephone_number": "770-744-4581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN AND TEEN DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-30",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "JORDAN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "470-801-4637"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dacula, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.