TEBO DENTISTRY FOR KIDS PEACHTREE CORNERS, LLC (NPI# 1083172035) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083172035 |
| Entity Type | Organization |
| Organization Name | TEBO DENTISTRY FOR KIDS PEACHTREE CORNERS, LLC |
| Practice Address |
6460 Spalding Drive Suite C Peachtree Corners GA 30092 |
| Mailing Address |
Po Box 1953 Lilburn GA 30048 |
| Practice Telephone | 7709253300 |
| Enumeration Date | 2019-03-08 |
| Last Update Date | 2019-06-11 |
| Authorized Official Name | MARK THEBAUT (PRESIDENT/OWNER) |
| Authorized Official Telephone | 7709253300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Tebo Dentistry for Kids Peachtree Corners | Doing Business As Name - Organization |
| Street Address |
6460 SPALDING DRIVE SUITE C |
| City | PEACHTREE CORNERS |
| State | GA |
| Zip Code | 30092 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043794472 | Cai Hong Senior Services Inc | Clinic/Center | 4093 Spalding Hollow, Peatree Corners, GA 30092 | 2018-09-21 |
| 1952810566 | Children In Motion Therapy Services LLC | Occupational Therapist | 5655 Peachtree Pkwy Ste 117, Norcross, GA 30092 | 2017-09-26 |
| 1922517945 | Infinity Wellness Solutions LLC | Emergency Medicine | 3240 Pointe Parkway, Suite 100, Norcross, GA 30092 | 2017-09-21 |
| 1346769593 | Global Diagnostic Labs, LLC | Pathology | 3240 Pointe Pkwy Ste 200, Norcross, GA 30092 | 2017-09-19 |
| 1467993345 | Boris Mcguire Day | Counselor | 3597 Monticello Commons, Norcross, GA 30092 | 2017-03-13 |
| 1598205239 | Iwc East LLC | Internal Medicine | 40 Technology Parkway, #300, Norcross, GA 30092 | 2017-02-28 |
| 1851744254 | Lms Surgical Services | Specialist/Technologist, Other | 6050 Peachtree Pkwy Suite240-358, Norcross, GA 30092 | 2016-07-20 |
| 1881085603 | A Hand To Hold | Home Health | 3459 Holcomb Bridge Rd., Suite 100, Peachtree Corners, GA 30092 | 2015-02-16 |
| 1790196467 | Wranglehurst, P.C. | Dentist | 3850 Holcomb Br. Rd, Suite 230, Norcross, GA 30092 | 2014-05-15 |
| 1013259829 | Scarlet Adana Chatman | Early Intervention Provider Agency | 3391 Peachtree Corners Circle, Apt H, Norcross, GA 30092 | 2013-03-19 |
| Find all providers in zip 30092 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922606490 | Smile Pleasant Hill LLC | Clinic/Center | 828 Pleasant Hill Rd Nw Ste 10, Lilburn, GA 30047-2757 | 2020-10-15 |
| 1982213583 | Munoz Dental Resources LLC | Clinic/Center | 4141 Steve Reynolds Blvd Ste 1, Norcross, GA 30093-3060 | 2020-07-29 |
| 1407474794 | Familia Dentistry of Georgia, LLC | Clinic/Center | 4574 Lawrenceville Hwy Nw Ste 120r, Lilburn, GA 30047-3605 | 2020-07-13 |
| 1336763648 | Bethlehem Orthodontics | Clinic/Center | 426 Exchange Blvd Ste 400, Bethlehem, GA 30620-1791 | 2020-06-02 |
| 1770106882 | Smiles By Dixon PC | Clinic/Center | 690 Lanier Park Dr, Gainesville, GA 30501-2061 | 2020-05-22 |
| 1811516479 | Mouthpeace Dental 4, LLC | Clinic/Center | 541 Forest Pkwy Ste 18, Forest Park, GA 30297-6110 | 2020-04-14 |
| 1427677541 | Mh Dental Group, LLC | Clinic/Center | 1305 Cedarcrest Rd Ste 115, Dallas, GA 30132-8201 | 2020-04-09 |
| 1104451160 | Sno Healthcare Group | Clinic/Center | 2424 Roswell Rd Ste 120, Marietta, GA 30062 | 2020-03-10 |
| 1952935710 | West Cobb Periodontics and Implant Dentistry LLC | Clinic/Center | 44 Old Hamilton Rd Nw Ste 200, Marietta, GA 30064-5901 | 2020-03-02 |
| 1659904241 | Dental Now Kids LLC | Clinic/Center | 4151 Steve Reynolds Blvd Ste 2, Norcross, GA 30093-3060 | 2020-02-21 |
| Find all providers with the same taxonomy | ||||
| City | PEACHTREE CORNERS |
| Zip Code | 30092 |
Please comment or provide details below to improve the information on TEBO DENTISTRY FOR KIDS PEACHTREE CORNERS, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.