Superior Dental of East Cobb, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN012980 Issued in GA

Legal business name

SUPERIOR DENTAL OF EAST COBB, LLC

Practice address

2745 Sandy Plains Rd Ste 118
Marietta, GA 30066-4327

Phone

(770) 977-1611

NPI assigned

Jan 29, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Bobby T Shirley, DMD

Title

Owner

Phone

(678) 977-8119

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.

• Stanley A Stein, D.M.D.

  • General Practice Dentistry
  • Marietta, GA
  • NPI 1306976972
  NPD (past)

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517184000000",
    "number": "1982102653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 LIGHTBURN CRK NW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300641307",
            "telephone_number": "678-977-8119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2745 SANDY PLAINS RD STE 118",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300664327",
            "telephone_number": "770-977-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR DENTAL OF EAST COBB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-29",
        "last_updated": "2018-01-29",
        "status": "A",
        "authorized_official_last_name": "SHIRLEY",
        "authorized_official_first_name": "BOBBY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-977-8119",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Sunny
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• Suann Surdick Surdick, PA-C

• 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 Jan 29, 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.