CEDAR DENTAL CLINICAL I, LLC (NPI# 1366059396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366059396 |
| Entity Type | Organization |
| Organization Name | CEDAR DENTAL CLINICAL I, LLC |
| Practice Address |
18 Riverbend Dr Sw Ste 230 Rome GA 30161-6019 |
| Mailing Address |
6801 Governors Lake Pkwy Ste 290 Peachtree Corners GA 30071-1136 |
| Practice Telephone | 7065918192 |
| Practice Fax Number | 7065918103 |
| Mailing Telephone | 6789783099 |
| Mailing Fax Number | 6786914425 |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2020-09-24 |
| Authorized Official Name | MR. HENRY RANKIN DALLAM III (PRESIDENT) |
| Authorized Official Telephone | 7703312529 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | GA DENTAL LICENSE | DN013071 | 01 |
| Other Name | Type Code |
|---|---|
| Orthodontic Care of Georgia | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003423039 | Cedar Dental Clinical I, LLC | Dentist | 119 Willow Ln, Mcdonough, GA 30253-6574 | 2020-09-24 |
| 1073120002 | Cedar Dental Clinical I, LLC | Dentist | 494 Booth Rd Ste 1a, Warner Robins, GA 31088-3435 | 2020-09-24 |
| 1942817960 | Cedar Dental Clinical I, LLC | Dentist | 4272 Washington Rd Ste 7a, Evans, GA 30809-3073 | 2020-09-24 |
| 1740897776 | Cedar Dental Clinical I, LLC | Dentist | 3630 Thompson Bridge Rd Ste 18b, Gainesville, GA 30506-1524 | 2020-09-24 |
| 1790392710 | Cedar Dental Clinical I, LLC | Dentist | 6801 Governors Lake Pkwy Ste 290, Peachtree Corners, GA 30071-1136 | 2020-09-24 |
| Street Address |
18 RIVERBEND DR SW STE 230 |
| City | ROME |
| State | GA |
| Zip Code | 30161-6019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265069256 | Three Rivers Housing and Development Corporation | Chore Provider | 326 W. 9th St, Rome, GA 30161 | 2020-03-27 |
| 1144865957 | Eric Alan Fuller | Audiologist-Hearing Aid Fitter | 700 East 2nd Street, Suite C, Rome, GA 30161 | 2019-11-15 |
| 1003394883 | Cindy V Shelton | Health Educator | 204 E 1st Ave, Rome, GA 30161 | 2018-08-02 |
| 1083153597 | Julie Oglesby Allen | Counselor | 1 S Broad St Sw Ste 5, Rome, GA 30161 | 2017-02-16 |
| 1902299530 | Michael Thomas Phillips | Pharmacist | 2005 Maple Street, Rome, GA 30161 | 2015-03-06 |
| 1407259112 | Angela Smith | Community/Behavioral Health | 109 John Maddox Suite 200, Rome, GA 30161 | 2014-10-08 |
| 1215344379 | Nancy Patel | Pharmacist | 1421 North Broad St, Rome, GA 30161 | 2014-07-21 |
| 1821336629 | Wendy Pence | Nurse Practitioner | 3001 Turner Mccall Blvd, Rome, GA 30161 | 2013-01-29 |
| 1558526202 | Marilyn Teresa Ringstaff | Registered Nurse | 1513 Dean St., Rome, GA 30161 | 2008-07-22 |
| 1134310147 | Reneka L Dobbs-jackson | Family Medicine | 420 E 2nd Ave Ste 103, Rome, GA 30161 | 2007-08-05 |
| Find all providers in zip 30161 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710057088 | Joseph Kent Vargo | Dentist | 419 East Second Avenue, Rome, GA 30161 | 2006-11-08 |
| 1871600932 | Richard J Klockowski | Dentist | 306 West Liberty St, Rome, NY 13440-5744 | 2006-08-24 |
| 1336153592 | Benjamin M Pridemore Jr. | Dentist | 23 John Maddox Dr Nw, Rome, GA 30165-1413 | 2006-07-27 |
| 1790143899 | Foundations Orthodontics LLC | Dentist | 317 Redmond Rd Nw, Rome, GA 30165-1539 | 2016-02-03 |
| 1386087500 | William Bennett | Dentist | 317 Redmond Rd Nw, Rome, GA 30165-1539 | 2013-04-08 |
| 1982900817 | Ryan Jeffery Cox | Dentist | 23 John Maddox Dr Nw, Rome, GA 30165-1413 | 2011-02-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144828765 | Sharma Orthodontics LLC | Dentist | 3535 Roswell Rd Ste 53, Marietta, GA 30062-8828 | 2020-10-15 |
| 1700484094 | Beltway Orthodontics | Dentist | 857 Collier Rd Nw Ste 5a-5b, Atlanta, GA 30318-2532 | 2020-10-09 |
| 1003423039 | Cedar Dental Clinical I, LLC | Dentist | 119 Willow Ln, Mcdonough, GA 30253-6574 | 2020-09-24 |
| 1073120002 | Cedar Dental Clinical I, LLC | Dentist | 494 Booth Rd Ste 1a, Warner Robins, GA 31088-3435 | 2020-09-24 |
| 1942817960 | Cedar Dental Clinical I, LLC | Dentist | 4272 Washington Rd Ste 7a, Evans, GA 30809-3073 | 2020-09-24 |
| 1740897776 | Cedar Dental Clinical I, LLC | Dentist | 3630 Thompson Bridge Rd Ste 18b, Gainesville, GA 30506-1524 | 2020-09-24 |
| 1790392710 | Cedar Dental Clinical I, LLC | Dentist | 6801 Governors Lake Pkwy Ste 290, Peachtree Corners, GA 30071-1136 | 2020-09-24 |
| 1598379679 | Dr. Milan Dhanani PC | Dentist | 1905 Beaver Ruin Rd Ste 175b, Norcross, GA 30071-3837 | 2020-09-04 |
| 1316584758 | Classic City Orthodontics, LLC | Dentist | 1020 Jamestown Blvd Bldg 100, Watkinsville, GA 30677-4131 | 2019-12-04 |
| 1952957714 | Melisa Stewart | Dentist | 5555 Peachtree Dunwoody Rd Ste 301, Atlanta, GA 30342-1712 | 2019-08-16 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on CEDAR DENTAL CLINICAL I, 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.