Family Dentistry of Marietta, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN012338 Issued in GA

Legal business name

FAMILY DENTISTRY OF MARIETTA, LLC

Practice address

2125 Post Oak Tritt Rd
Marietta, GA 30062-1609

Phone

(770) 977-9090

NPI assigned

Oct 1, 2009

Last updated

Oct 1, 2009By 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

Dr. Logan V Gordon

Title

Business Manager

Phone

(770) 977-9090

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Roddie Crouch, DDS

  • General Practice Dentistry
  • Marietta, GA
  • NPI 1528294238
  NPD (past)

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254355200000",
    "number": "1972837318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 POST OAK TRITT RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300621609",
            "telephone_number": "770-977-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 POST OAK TRITT RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300621609",
            "telephone_number": "770-977-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTISTRY OF MARIETTA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-01",
        "last_updated": "2009-10-01",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "LOGAN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "770-977-9090",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hallie Jaye Faley
• Warren Falo, MD
• Family Care Facility Network Inc.
• Family Chiropractic Office
• Family Dental Centers of Marietta, P.C. (Family Dental Solutions)
• Family Direct Healthcare Services Inc
• Family First Vision Care Georgia
• Family Hearing and Speech Center of West Cobb, Inc. (Hearing Solutions)
• Family Home Care, LLC
• Family Home Medical Equipment LLC (Total Respiratory)

• General Practice Dentistry in Marietta, GA
• Providers in Marietta, 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 Oct 1, 2009; 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.