Imagix Dental of Johns Creek LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

IMAGIX DENTAL OF JOHNS CREEK LLC

Practice address

4245 Johns Creek Pkwy
Suite C
Suwanee, GA 30024-9121

Phone

(678) 990-5980

NPI assigned

Jun 29, 2015

Organization subpart

No

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

Authorized official

Name

Mike Cole

Title

VP Insurance Plan Management

Phone

(727) 726-1611

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435536000000",
    "number": "1992187710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4245 JOHNS CREEK PKWY",
            "address_2": "SUITE C",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300249121",
            "telephone_number": "678-990-5980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4245 JOHNS CREEK PKWY",
            "address_2": "SUITE C",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300249121",
            "telephone_number": "678-990-5980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGIX DENTAL OF JOHNS CREEK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-29",
        "last_updated": "2015-06-29",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "VP INSURANCE PLAN MANAGEMENT",
        "authorized_official_telephone_number": "727-726-1611"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2015; 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.