DENTISTRY FOR CHILDREN OF JONESBORO, LLC


Address: 435 Arrowhead Blvd, Jonesboro, GA 30236-1219
Phone: 7704788400

DENTISTRY FOR CHILDREN OF JONESBORO, LLC (NPI# 1083915896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1083915896
Entity Type Organization
Organization Name DENTISTRY FOR CHILDREN OF JONESBORO, LLC
Practice Address 435 Arrowhead Blvd
Jonesboro
GA 30236-1219
Mailing Address 295 Country Club Dr
Stockbridge
GA 30281-7350
Practice Telephone 7704788400
Practice Fax Number 7704738766
Mailing Telephone 7704731350
Mailing Fax Number 7706920098
Enumeration Date 2010-11-10
Last Update Date 2010-11-10
Authorized Official Name DR. CHARLES COULTER (PEDIATRIC DENTIST)
Authorized Official Telephone 7704731350
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 1223G0001X Dentist
Specialization: General Practice
Dental Providers
Y 1223P0221X Dentist
Specialization: Pediatric Dentistry
Dental Providers

Office Location

Street Address 435 ARROWHEAD BLVD
City JONESBORO
State GA
Zip Code 30236-1219

Providers in the same location

NPI Name Taxonomy Address Enumeration
1164411674 Dentistry for Children Dentist 435 Arrowhead Blvd, Jonesboro, GA 30236-1219 2005-10-18
1801225305 Tom Harmon Dentist 435 Arrowhead Blvd, Ste 100, Jonesboro, GA 30236-1219 2013-11-05
1336410182 Mariel Nortick Dentist 435 Arrowhead Blvd, Jonesboro, GA 30236-1219 2012-01-24
1609959345 Jonesboro Dental Associates Dentist 435 Arrowhead Blvd, Suite 100, Jonesboro, GA 30236-1219 2006-10-24
1902829161 Brad Warren Roehl Dentist 435 Arrowhead Blvd, Jonesboro, GA 30236-1219 2006-07-26
1114992724 Antonia R Williams Dentist 435 Arrowhead Blvd, Jonesboro, GA 30236-1219 2006-02-18

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1972123362 Life Source Counseling & Consulting, LLC Clinic/Center 118 North Avenue, Suite A, Jonesboro, GA 30236 2020-04-25
1639609555 New Beginnings Behavioral Counseling,llc Social Worker 9456 S Main St Ste E2, Jonesboro, GA 30236 2017-06-13
1437696762 Clarissa Alexandra Poole Counselor 2106 Fair Ridge Ct, Jonesboro, GA 30236 2017-01-25
1588012892 Sundance Healthcare Service Inc In Home Supportive Care 7861 Collinswood Court, Jonesboro, GA 30236 2016-05-26
1942669205 Adrianne Smiley Gurley Occupational Therapist 1299 Battlecreek Rd Ste 210, Jonesboro, GA 30236 2016-02-15
1336505809 Integrated Health Center Dentist 8600 Tara Blvd, Suite D, Jonesboro, GA 30236 2016-01-13
1467827402 Surrell Porter Nurse Practitioner 1287 Georgia Highway 138 Spur, Suite 8, Jonesboro, GA 30236 2015-12-02
1740688910 Jacqueline Carolyn Edwards Registered Nurse 8081 Tara Blvd, 265, Jonesboro, GA 30236 2014-12-19
1770991861 Lower Extremity Diagnostics, LLC Podiatrist 6911 Tara Boulevard, Jonesboro, GA 30236 2014-08-01
1760899710 Fresenius Medical Care Jonesboro, LLC Clinic/Center 8060 Summitt Business Parkway, Jonesboro, GA 30236 2014-07-22
Find all providers in zip 30236

Taxonomy Information

Taxonomy Code 1223P0221X
Grouping Dental Providers
Classification Dentist
Specialization Pediatric Dentistry

Taxonomy Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1720242167 Summer Barker Tyson Dentist 620 Southwest Dr, Jonesboro, AR 72401-5859 2008-07-15
1790909752 Ken Wood, D.d.s. M.s. Childrens Dentistry Dentist 2702 S Culberhouse St, Suite Q, Jonesboro, AR 72401-7132 2007-04-12
1447310883 Michael Douglas Oliver Jr. Dentist 809 Windover Rd, Jonesboro, AR 72401-6010 2006-12-08
1548360001 Ken I Wood Dentist 2702 Culberhouse, Southwest Village, Jonesboro, AR 72401 2006-09-25
1164411674 Dentistry for Children Dentist 435 Arrowhead Blvd, Jonesboro, GA 30236-1219 2005-10-18
1861937518 Axpm Jonesboro Pedo, Pllc Dentist 1150 E Matthews Ave, Ste 102, Jonesboro, AR 72401-4346 2017-01-04
1225402373 Homegrown Pediatric Dentistry and Orthodontics Dentist 405 Arrowhead Blvd, Jonesboro, GA 30236-1254 2015-11-30
1801181672 Clemmisa Louise Harris Dentist 809 Windover Rd, Jonesboro, AR 72401-6010 2011-06-09
1538453006 Tyson Dental Associates Pllc Dentist 620 Southwest Dr, Jonesboro, AR 72401-5859 2011-06-02
1689791519 Angel M Guardiola Dentist 405 Arrowhead Blvd, Jonesboro, GA 30236-1254 2007-03-24
Find all providers in JONESBORO

Competitor

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City JONESBORO
Zip Code 30236

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Dataset Information

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.

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