GEORGIA DENTAL PROFESSIONALS, PC (NPI# 1255940839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255940839 |
| Entity Type | Organization |
| Organization Name | GEORGIA DENTAL PROFESSIONALS, PC |
| Practice Address |
4090 Jiles Rd Nw Kennesaw GA 30144-1105 |
| Practice Telephone | 4705190483 |
| Mailing Telephone | 4705190483 |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2020-07-29 |
| Authorized Official Name | JESSICA BRITT (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 2175405100 |
| Is Organization Subpart | Y |
| Parent Organization Name | GEORGIA DENTAL PROFESSIONALS, PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Baker Road Dental Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760098214 | Georgia Dental Professionals, PC | Dentist | 3000 Chapel Hill Rd Ste 104, Douglasville, GA 30135-1841 | 2020-09-21 |
| 1063028769 | Georgia Dental Professionals, PC | Dentist | 3364 Hamilton Mill Rd, Buford, GA 30519-4005 | 2020-09-17 |
| 1306452016 | Georgia Dental Professionals, PC | Dentist | 2680 Highway 34 E Ste A, Newnan, GA 30265-1330 | 2020-09-17 |
| 1720693690 | Georgia Dental Professionals, PC | Dentist | 3625 Browns Bridge Rd Ste 101, Cumming, GA 30028-4198 | 2020-09-09 |
| 1285242693 | Georgia Dental Professionals, PC | Dentist | 5185 Peachtree Pkwy Ste 201, Norcross, GA 30092-6539 | 2020-07-22 |
| 1780220194 | Georgia Dental Professionals, PC | Dentist | 4355 Towne Lake Pkwy, Woodstock, GA 30189-8150 | 2019-11-20 |
| 1831746999 | Georgia Dental Professionals, PC | Dentist | 1207 Highway 74 S, Peachtree City, GA 30269-3078 | 2019-08-23 |
| 1972165207 | Georgia Dental Professionals, PC | Dentist | 516 Ga Highway 247 S, Bonaire, GA 31005-3865 | 2019-07-08 |
| 1710546148 | Georgia Dental Professionals, PC | Dentist | 8022 Cumming Hwy, Canton, GA 30115-9337 | 2019-06-10 |
| 1730747528 | Georgia Dental Professionals, PC | Dentist | 920 Loganville Hwy Ste 100, Bethlehem, GA 30620 | 2019-06-05 |
| Street Address |
4090 JILES RD NW |
| City | KENNESAW |
| State | GA |
| Zip Code | 30144-1105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265059364 | Abboss Sharifzadeh | Dentist | 4090 Jiles Rd Nw, Kennesaw, GA 30144-1105 | 2020-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205440054 | Physician Assistant Surgical Solutions | Surgery | 4290 Bells Ferry Road, Suite 134 - 1032, Kennesaw, GA 30144 | 2020-08-31 |
| 1487149340 | Creative Family Care Inc. | Social Worker | 1275 Shiloh Rd Nw Ste 3030, Kennesaw, GA 30144 | 2018-06-24 |
| 1033632203 | Octavio Andres Tobar | Specialist/Technologist | 1950 Barrett Lakes Blvd Nw Apt 1213, Kennesaw, GA 30144 | 2017-07-19 |
| 1851829220 | Sharon Mcmillan | Counselor | 1301 Shiloh Rd Nw Ste 1840, Kennesaw, GA 30144 | 2017-05-31 |
| 1073054680 | Metropolitan Health Care Plus Inc | Home Health | 445 Laurian Way, Kennesaw, GA 30144 | 2017-03-15 |
| 1649627969 | Caresouth Hha Holdings of Gainesville, LLC | Hospice Care, Community Based | 1000 Cobb Place Blvd Nw Ste 310, Kennesaw, GA 30144 | 2016-05-17 |
| 1851745988 | Joseph Mulligan | Social Worker | 1301 Shiloh Rd., Ste. 849, Kennesaw, GA 30144 | 2016-04-14 |
| 1629438601 | Youfit Health Clubs | Clinic/Center | 3895 Cherokee St Suite 100, Kennesaw, GA 30144 | 2016-03-03 |
| 1598156317 | Jodie Evans | Specialist | 1925 Vaughn Rd, Ste 200, Kennesaw, GA 30144 | 2015-02-16 |
| 1912302134 | Sleepmed Therapies, Inc. | Durable Medical Equipment & Medical Supplies | 1000 Cobb Place Blvd Nw Ste 510, Kennesaw, GA 30144 | 2014-10-30 |
| Find all providers in zip 30144 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467006510 | Ronald Edward Durie Jr. | Dentist | 1955 N Cobb Pkwy Nw Ste 110, Kennesaw, GA 30152-4503 | 2019-07-27 |
| 1437636321 | Jetoria Irving | Dentist | 1200 Ernest W Barrett Pkwy Nw Ste 200, Kennesaw, GA 30144-4513 | 2018-07-24 |
| 1184143059 | Kennesaw Mountain Dental Associates | Dentist | 1815 Old 41 Hwy, Ste 310, Kennesaw, GA 30152 | 2017-09-12 |
| 1366602286 | David Molina | Dentist | 4290 Bells Ferry Rd Nw Ste 136, Kennesaw, GA 30144-1768 | 2008-06-13 |
| 1770788572 | Tia Harding | Dentist | 5255 Stilesboro Rd Nw Ste 150, Kennesaw, GA 30152-7738 | 2007-06-20 |
| 1952502528 | Lizzette Garcia Edge | Dentist | 3420 Acworth Due West Rd Nw Ste A, Kennesaw, GA 30144-2371 | 2007-05-30 |
| 1265643977 | Edge Center for Family Dentistry | Dentist | 3420 Acworth Due West Rd, Suite A, Kennesaw, GA 30144 | 2007-05-24 |
| 1710003488 | Bruce A. Hester, D.m.d., P.C. | Dentist | 2980 Lewis St Nw, Kennesaw, GA 30144-5635 | 2007-03-22 |
| 1871617647 | Douglas Jay Deuchar | Dentist | 3903 Jiles Rd., Building 100, Suite 111, Kennesaw, GA 30144 | 2007-03-19 |
| 1326194861 | Patsy Usberghi | Dentist | 2105 Barrett Park Dr Nw, Kennesaw, GA 30144-7080 | 2007-01-26 |
| Find all providers in KENNESAW | ||||
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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.