MUSTARD SEED PEDIATRIC DENTISTRY, LLC (NPI# 1093048563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093048563 |
| Entity Type | Organization |
| Organization Name | MUSTARD SEED PEDIATRIC DENTISTRY, LLC |
| Practice Address |
1120 Peachtree Industrial Blvd Suite 203 and 204 Suwanee GA 30024-2013 |
| Practice Telephone | 7709047005 |
| Practice Fax Number | 7709047075 |
| Mailing Telephone | 7709047005 |
| Mailing Fax Number | 7709047075 |
| Enumeration Date | 2009-09-15 |
| Last Update Date | 2009-09-15 |
| Authorized Official Name | YOO MEE KIM (DENTIST/OWNER) |
| Authorized Official Telephone | 7709047005 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DN013415 | GA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | INDIVIDUAL NPI # | 1255479689 | 01 |
| Street Address |
1120 PEACHTREE INDUSTRIAL BLVD SUITE 203 AND 204 |
| City | SUWANEE |
| State | GA |
| Zip Code | 30024-2013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790897494 | Glenda B Brown | Optometrist | 1120 Peachtree Industrial Blvd, Ste 101, Suwanee, GA 30024-2013 | 2006-08-31 |
| 1366838534 | Peachtree Pediatric Urgent Care, LLC | Pediatrics | 1120 Peachtree Industrial Blvd, 201, Suwanee, GA 30024-2013 | 2015-04-14 |
| 1659636694 | Thomas Eye Group PC | Ophthalmology | 1120 Peachtree Industrial Blvd, Ste 101, Suwanee, GA 30024-2013 | 2012-07-05 |
| 1659662039 | Turkessa Lashelle Williams | Dental Assistant | 1120 Peachtree Industrial Blvd, Ste. 203, Suwanee, GA 30024-2013 | 2011-04-20 |
| 1285925669 | Wan Kim | Dental Assistant | 1120 Peachtree Industrial Blvd, #203, Suwanee, GA 30024-2013 | 2011-04-20 |
| 1811222623 | Soft Touch Endodontics, PC | Health Maintenance Organization | 1120 Peachtree Industrial Blvd, Suite 205, Suwanee, GA 30024-2013 | 2009-10-13 |
| 1538379862 | Darlene Marie Davis | Dentist | 1120 Peachtree Industrial Blvd, Suite 205, Suwanee, GA 30024-2013 | 2007-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356996565 | Stephanie Arkin | Student in an Organized Health Care Education/Training Program | 25 Old Peachtree Rd Nw, Suwanee, GA 30024 | 2019-08-05 |
| 1164989638 | Laquitta Craft | Registered Nurse | 2855 Lawrenceville Suwanee Road Suite 330/340, Suwanee, GA 30024 | 2019-02-21 |
| 1467937235 | Greater Atlanta Monitoring, LLC | Electrodiagnostic Medicine | 3651 Peachtree Ste E. #331, Suwanee, GA 30024 | 2018-09-27 |
| 1760963482 | Esther Natacha Lafontant | Public Health or Welfare | 3205 Maple Terrace Drive, Suwanee, GA 30024 | 2018-08-22 |
| 1740778463 | Immaculate Healthcare Solutions, LLC | Home Health | 970 Peachtree Industrial Blvd Ste 8, Suwanee, GA 30024 | 2018-04-27 |
| 1053819235 | Sean Wonsuk Jang | Chiropractor | 3370 Lawrenceville Suwanee Rd Ste 118, Suwanee, GA 30024 | 2018-01-23 |
| 1932628468 | Silver Health Services, Inc. | Case Manager/Care Coordinator | 2640 Westbury Court, Swanee, GA 30024 | 2017-09-15 |
| 1285159095 | April L. Rivers | Nurse Practitioner | 4411 Suwanee Dam Rd Ste 110, Suwanee, GA 30024 | 2017-08-14 |
| 1144743840 | Nabil Elkareh | Pharmacist | 5049 Tarry Glen Drive., Suwanee, GA 30024 | 2017-07-25 |
| 1720508294 | Robert A Finkel Dds PC | Clinic/Center | 1325 Satellite Blvd Nw Ste 1304, Suwanee, GA 30024 | 2017-06-26 |
| Find all providers in zip 30024 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922490333 | Shelley Danielle Wade Berganske | Dentist | 1380 Peachtree Industrial Blvd Ste 150, Suwanee, GA 30024-3795 | 2015-02-21 |
| 1295048163 | Shrenik Shah | Dentist | 350 Town Center Ave Ste 301, Suwanee, GA 30024-6914 | 2010-07-21 |
| 1699843052 | Lisa Koh Lee | Dentist | 1299 Old Peachtree Rd Nw, Suite 102, 103, Suwanee, GA 30024-2028 | 2006-12-01 |
| 1245347814 | Michael Richard Hansen | Dentist | 4330 Johns Creek Parkway, Suwanee, GA 30024 | 2006-08-23 |
| 1285077933 | Gwinnett Pediatric Dentistry | Dentist | 2650 Lawrenceville Suwanee Rd, Suite D, Suwanee, GA 30024-2535 | 2013-04-12 |
| 1164551081 | Rhonda Corey Hogan | Dentist | 1380 Peachtree Industrial Blvd, Suite 150, Suwanee, GA 30024-3769 | 2007-03-05 |
| 1306982699 | Cynthia Jones II | Dentist | 3525 Lawrenceville Suwanee Rd, Suwanee, GA 30024 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740895002 | Ashley Starnesdmd LLC | Dentist | 5482 Chamblee Dunwoody Rd Ste 9, Dunwoody, GA 30338-4142 | 2020-09-14 |
| 1912518531 | Samuel S Kwon - Athens Dmd PC | Dentist | 1795 Resurgence Drive, Suite 101, Watkinsville, GA 30677 | 2020-08-17 |
| 1366060618 | A Dental Home 4 Kidz | Dentist | 155 Carnegie Pl Ste 201, Fayetteville, GA 30214-3981 | 2020-07-13 |
| 1255973566 | Rehoboth Life Care Ministries, Inc | Dentist | 3208 Hwy 41, Byron, Byron, GA 31008 | 2019-10-09 |
| 1629619200 | Peachtree Hills Pediatric Dentistry | Dentist | 2385 Peachtree Rd Ne Ste A2ab, Atlanta, GA 30305-4139 | 2019-10-04 |
| 1871145557 | Dogwood Pediatric Dentistry of Statesboro, LLC | Dentist | 123 Hill Pond Ln, Statesboro, GA 30458-0872 | 2019-07-12 |
| 1952969396 | Ns3 Services, LLC | Dentist | 1039 Grant St Se Ste B11, Atlanta, GA 30315-2050 | 2019-05-31 |
| 1871050872 | Warner Robins Pediatric Dentistry LLC | Dentist | 102 S Houston Rd, Warner Robins, GA 31088-3904 | 2019-02-26 |
| 1730646886 | Smiles for Kids Norcross PC | Dentist | 3953 Holcomb Bridge Rd Ste 100, Peachtree Corners, GA 30092-5201 | 2019-02-25 |
| 1073083127 | Pediatric Dentistry of Central Georgia - Macon LLC | Dentist | 5437 Bowman Rd Ste 300, Macon, GA 31210-6575 | 2018-12-03 |
| Find all providers with the same taxonomy | ||||
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| 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.