Mouthpeace Dental 5 LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MOUTHPEACE DENTAL 5 LLC

Practice address

2655 S Cobb Dr SE
Smyrna, GA 30080-1873

Phone

(312) 371-1423

NPI assigned

Mar 12, 2025

Organization subpart

No

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

Authorized official

Name

Syretta Wells, DDSNPI 1184875882

Title

President

Phone

(312) 371-1423

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Syretta Wells, DDS

  • Prosthodontics
  • Forest Park, GA
  • NPI 1184875882
  NPD Authorized official

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

{
    "created_epoch": "1741737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741737600000",
    "number": "1982403887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950008",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303772008",
            "telephone_number": "312-371-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 S COBB DR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300801873",
            "telephone_number": "312-371-1423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUTHPEACE DENTAL 5 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-12",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "SYRETTA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-371-1423",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Smyrna, GA
• Providers in Smyrna, 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 12, 2025; 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.