HOMEGROWN PEDIATRIC DENTISTRY AND ORTHODONTICS


Address: 405 Arrowhead Blvd, Jonesboro, GA 30236-1254
Phone: 7704711991

HOMEGROWN PEDIATRIC DENTISTRY AND ORTHODONTICS (NPI# 1225402373) 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) 1225402373
Entity Type Organization
Organization Name HOMEGROWN PEDIATRIC DENTISTRY AND ORTHODONTICS
Practice Address 405 Arrowhead Blvd
Jonesboro
GA 30236-1254
Mailing Address 1005 Timber Lake Dr
Cumming
GA 30041-8606
Practice Telephone 7704711991
Mailing Telephone 3862126669
Enumeration Date 2015-11-30
Last Update Date 2015-11-30
Authorized Official Name CHRISTINA MCKELLAR (MEMBER/ PEDIATRIC DENTIST)
Authorized Official Telephone 3862126669
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223P0221X Dentist
Specialization: Pediatric Dentistry
DN014531 GA Dental Providers

Office Location

Street Address 405 ARROWHEAD BLVD
City JONESBORO
State GA
Zip Code 30236-1254

Providers in the same location

NPI Name Taxonomy Address Enumeration
1972508117 Barry Zeitman Dentist 405 Arrowhead Blvd, Jonesboro, GA 30236-1254 2005-06-15
1023626512 Anna Richards Speech-Language Pathologist 405 Arrowhead Blvd, Jonesboro, GA 30236-1254 2020-07-21
1700226438 Eva Lauren Runnels Nurse Anesthetist, Certified Registered 405 Arrowhead Blvd, Suite C, Jonesboro, GA 30236-1254 2013-06-26
1497010003 Lashawn Ealey Nurse Anesthetist, Certified Registered 405 Arrowhead Blvd, C, Jonesboro, GA 30236-1254 2012-07-10
1184876997 Barrett M. Hunter Dentist 405 Arrowhead Blvd, Jonesboro, GA 30236-1254 2008-10-13
1841453875 Jianmei Li Anesthesiologist Assistant 405 Arrowhead Blvd, Suite C, Jonesboro, GA 30236-1254 2008-07-09
1174782601 Jennifer L Cantrell Nurse Anesthetist, Certified Registered 405 Arrowhead Blvd, Suite C, Jonesboro, GA 30236-1254 2008-06-09
1104084201 Allison R Johns Anesthesiologist Assistant 405 Arrowhead Blvd, Suite C, Jonesboro, GA 30236-1254 2008-05-27
1568657807 Chareunphone T Inthirat Dentist 405 Arrowhead Blvd, Jonesboro, GA 30236-1254 2007-09-10
1740481381 Jared Charles Kutzer Anesthesiologist Assistant 405 Arrowhead Blvd, Suite C, Jonesboro, GA 30236-1254 2007-05-30
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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
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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
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
1902829161 Brad Warren Roehl Dentist 435 Arrowhead Blvd, Jonesboro, GA 30236-1219 2006-07-26
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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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