Beautiful Smiles of College Park LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN012765 Issued in GA

Legal business name

BEAUTIFUL SMILES OF COLLEGE PARK LLC

Practice address

6175 Old National Hwy Ste 430
Atlanta, GA 30349-4470

Phone

(770) 907-2666

NPI assigned

Feb 8, 2012

Last updated

Feb 8, 2012By 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. Paul R McKoy, DDS

Title

President

Phone

(678) 517-8368

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328659200000",
    "number": "1992077804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6175 OLD NATIONAL HWY STE 430",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303494470",
            "telephone_number": "770-907-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6175 OLD NATIONAL HWY STE 430",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303494470",
            "telephone_number": "770-907-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUTIFUL SMILES OF COLLEGE PARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-08",
        "last_updated": "2012-02-08",
        "status": "A",
        "authorized_official_last_name": "MCKOY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-517-8368",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neena Konadu Beausoleil, MSW
• Robin Beautelus
• Beautiful Mindz ABA Center LLC (Beautiful Mindz ABA Center)
• Beautiful Smiles at MLK
• Beautiful Smiles Inc.
• Beautiful Smiles Orthodontics, LLC
• Beautifulll Wigs, LLC
• Beauty Aesthetics LLC
• Sarah Joie Beauvais
• Stephanie Beauvais

• 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 Feb 8, 2012; 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.