Fabulous Smiles P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN011947 Issued in GA

Legal business name

FABULOUS SMILES P.C.

Practice address

1188 Ralph David Abernathy Blvd SW Ste 101
Atlanta, GA 30310-1754

Phone

(404) 767-9356

Fax

(404) 529-4465

NPI assigned

Oct 28, 2009

Organization subpart

Yes

Parent organization

FABULOUS SMILESAs reported in NPPES

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

Authorized official

Name

Aldous Wilson

Title

President

Phone

(404) 767-9356

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• FABULOUS SMILES PC Doing business as

Tax ID family

Fabulous Smilespc3 organizations share this tax ID, including this one

Part of

Fabulous Smilespc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Fabulous Smiles P.C.

  • General Practice Dentistry
  • Atlanta, GA
  • NPI 1619140928
  NPD tax ID
• Fabulous Smilesp.C.

  • General Practice Dentistry
  • Atlanta, GA
  • NPI 1235302563
  NPD tax ID

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

{
    "created_epoch": "1256688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256688000000",
    "number": "1982930806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1188 RALPH DAVID ABERNATHY BLVD SW STE 101",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303101754",
            "telephone_number": "404-767-9356",
            "fax_number": "404-529-4465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1188 RALPH DAVID ABERNATHY BLVD SW STE 101",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303101754",
            "telephone_number": "404-767-9356",
            "fax_number": "404-529-4465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FABULOUS SMILES P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FABULOUS SMILES",
        "enumeration_date": "2009-10-28",
        "last_updated": "2009-10-28",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "ALDOUS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-767-9356"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN011947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000809025E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FABULOUS SMILES PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Guillem Fabregas Gella
• Jorge Fabregas, MD
• Gail Diane Fabrizio, MS APRN BC
• Fabulous Smiles of Atlanta LLC
• Fabulous Smiles P.C.
• Fabulous Smilesp.C.
• Kristen Melissa Marie Facey, MD
• Facility Investments, L.P.
• Carl David Fackler, MD
• Stewart A Factor, D.O.

• General Practice Dentistry in Atlanta, GA
• Providers in Atlanta, 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 28, 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.