NPIMap

Organization Active NPI

Georgia Dental Professionals, PC

Doing business as Dental Care of Bonaire

  • General Practice Dentistry
  • Bonaire, GA
National Provider Identifier
1972165207
Registry record updated Aug 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
GEORGIA DENTAL PROFESSIONALS, PC
Doing business as
Dental Care of Bonaire
Practice address
516 Ga Highway 247 S
Bonaire, GA 31005-3865
Phone
(478) 273-2562
Fax
(478) 551-4152
NPI assigned
Jul 8, 2019
Last updated
Aug 8, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
GEORGIA DENTAL PROFESSIONALS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 8, 2019

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

Authorized official

Name
Jessica Britt
Title
Credentialing Coordinator
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

516 Ga Highway 247 S
Bonaire, GA 31005-3865

Mailing address

516 Ga Highway 247 S
Bonaire, GA 31005-3865

Other names 1

  • Dental Care of Bonaire Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Georgia Dental Professionals PC72 organizations share this tax ID, including this one
Part of
Georgia Dental Professionals PC

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

Locations

516 GA Highway 247 S
Bonaire, GA 31005
Phone (478) 273-2562

6005 Watson Blvd
Ste 200
Byron, GA 31008
Phone (478) 217-4952

104 S Houston Rd
Warner Robins, GA 31088
Phone (478) 922-2910

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 4

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": "1562544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565222400000",
    "number": "1972165207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 GA HIGHWAY 247 S",
            "city": "BONAIRE",
            "state": "GA",
            "postal_code": "310053865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 GA HIGHWAY 247 S",
            "city": "BONAIRE",
            "state": "GA",
            "postal_code": "310053865",
            "telephone_number": "478-273-2562",
            "fax_number": "478-551-4152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA DENTAL PROFESSIONALS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORGIA DENTAL PROFESSIONALS, PC",
        "enumeration_date": "2019-07-08",
        "last_updated": "2019-08-08",
        "status": "A",
        "authorized_official_last_name": "BRITT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care of Bonaire",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dental Care of Bonaire",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bonaire, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; 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.