Pedozone, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DNO14556 Issued in GA

Legal business name

PEDOZONE, LLC

Practice address

8879 Dallas Acworth Hwy
Dallas, GA 30132-7905

Phone

(770) 974-3633

Fax

(770) 974-3660

NPI assigned

Oct 19, 2017

Last updated

Mar 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Crystal Deann Smith

Title

Treatment Coordinator

Phone

(770) 974-3633

Specialties & licenses 1

Addresses

Locations

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.

• Candace Cronan, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Kennesaw, GA
  • NPI 1245684836
  NPD (past)
• Douglas Alexander Singleton, DDS, MS, PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Kennesaw, GA
  • NPI 1508968553
  NPD (past)

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

{
    "created_epoch": "1508371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1952812737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 CREEKSIDE VILLAGE DR NW STE 401",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442393",
            "telephone_number": "770-974-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8879 DALLAS ACWORTH HWY",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301327905",
            "telephone_number": "770-974-3633",
            "fax_number": "770-974-3660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12926 Highway 92",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "GA",
            "postal_code": "301885195",
            "country_code": "US",
            "telephone_number": "770-738-5437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PEDOZONE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-19",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "DEANN",
        "authorized_official_title_or_position": "TREATMENT COORDINATOR",
        "authorized_official_telephone_number": "770-974-3633",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "GA",
            "license": "DNO14556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paulding Medical Center (WellStar Pharmacy Network Store #4)
• Paulding Medical Center, Inc. (WellStar Paulding Nursing Center)
• Peaceful Path Counseling, LLC
• Cassandra Pearson
• Pediatric Dental Specialist of Acworth
• Suzanne Pengelly
• Frank Earle Penney III, DC
• Lilia Melisa Perez, RBT
• Arionne Perkins
• Audrey Perry

• Dental Clinic/Center in Dallas, GA
• Providers in Dallas, 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 Mar 17, 2018; 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.