J C SHIRLEY JR.


Address: 5455 Meridian Mark Rd, Suite 200, Atlanta, GA 30342
Phone: 4047852072

J C SHIRLEY JR. (NPI# 1386714103) 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) 1386714103
Entity Type Individual
Full Name J C SHIRLEY JR.
Credential DMD
Practice Address 5455 Meridian Mark Rd
Suite 200
Atlanta
GA 30342
Mailing Address 290 Powers Pl
Marietta
GA 30067
Practice Telephone 4047852072
Practice Fax Number 4047855892
Mailing Telephone 7703212682
Mailing Fax Number 7703211577
Enumeration Date 2006-11-09
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223P0221X Dentist
Specialization: Pediatric Dentistry
011647 GA Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
GA AVESIS 100864 01
GA DORAL 9182400 01

Office Location

Street Address 5455 MERIDIAN MARK RD
SUITE 200
City ATLANTA
State GA
Zip Code 30342

Providers in the same location

NPI Name Taxonomy Address Enumeration
1295799161 Glen Lew Pediatrics 5455 Meridian Mark Rd, Suite 400, Atlanta, GA 30342-1654 2006-04-17
1295279917 Lisa Sitz Nurse Practitioner 5455 Meridian Mark Rd, Atlanta, GA 30342 2016-12-14
1952757189 Lindsey Jacobs Nurse Practitioner 5455 Meridian Mark Rd, Suite 400, Atlanta, GA 30342-1654 2016-05-06
1982943452 Kimberly Nicole Steinberg Nurse Practitioner 5455 Meridian Mark Rd, Suite 130, Atlanta, GA 30342 2013-02-04
1184886947 Joanna Grossman Newton Pediatrics 5455 Meridian Mark Rd, Suite 400, Atlanta, GA 30342 2008-07-01
1205011954 Kristine Borden Whigham Clinical Neuropsychologist 5455 Meridian Mark Rd, Suite 180, Atlanta, GA 30342 2007-12-31
1275655326 Barunashish Brahma Neurological Surgery 5455 Meridian Mark Rd, Ste 540, Atlanta, GA 30342 2007-04-06
1255475091 Pediatric Neurosurgery Assoc At Children's Healthcare of Atlanta LLC Neurological Surgery 5455 Meridian Mark Rd, Suite 540, Atlanta, GA 30342 2007-02-16
1225063308 Robert N Vincent Pediatrics 5455 Meridian Mark Rd, Ste 530, Atlanta, GA 30342 2006-07-11
1043247257 Jack E Thomas Jr. Dentist 5455 Meridian Mark Rd, Ste 210, Atlanta, GA 30342 2006-06-26
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1144820614 Nia Charnice Griffin Nurse Practitioner 5670 Peachtree Dunwoodyroad, Suite 900, Atlanta, GA 30342 2020-10-26
1255945184 Jennifer Lynne Cole Behavior Technician 5555 Glenridge Con Suite 200, Atlanta, GA 30342 2020-09-08
1093336232 Van Tran Respiratory Therapist, Registered 1000 Johnson Ferry Rd Ne, Atlanta, Ga 30342, Atlanta, GA 30342 2020-04-28
1356978340 Twyla Douglas Jackson I Clinical Nutrition, 1000 Johnson Ferry Rd Ne, Atlanta, GA 30342 2020-03-27
1760013411 Emily Hamm Dietitian, Registered 933 D Johnson Ferry Road, Suite 250, Atlanta, GA 30342 2020-01-31
1043855984 Mackenzie Tucker Wayda Registered Nurse 1001 Johnson Ferry Rd. Ne, Atlanta, GA 30342 2019-11-14
1386288454 Tiauna Lashun Cochman Psychologist 1307 Glenridge Dr, Sandy Springs, GA 30342 2019-11-01
1164074399 Stephen J. White Hearing Instrument Specialist 5775 Peachtree Dunwoody Rd Suite 600 Fl. 6, Uhc Hearing, Atl., GA 30342 2019-07-09
1144788142 Jaytyn LLC Internal Medicine 4600 Broswell Road, Atlanta, GA 30342 2019-03-08
1760954705 Mishele Walker LLC Counselor 555 Glenridge Connector, Suite 200, Sandy Springs, GA 30342 2018-12-31
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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
1629619200 Peachtree Hills Pediatric Dentistry Dentist 2385 Peachtree Rd Ne Ste A2ab, Atlanta, GA 30305-4139 2019-10-04
1952969396 Ns3 Services, LLC Dentist 1039 Grant St Se Ste B11, Atlanta, GA 30315-2050 2019-05-31
1215336326 Esther Lee Dentist 270 17th St Nw Unit 1706, Atlanta, GA 30363-1248 2014-08-14
1679993430 Nikky Shotwell Dentist 2979 Silver Hill Ter., S.e., Atlanta, GA 30316-6715 2014-04-21
1932528577 Jaha V Howard Dds LLC Dentist 4300 Paces Ferry Rd Se Ste 405, Atlanta, GA 30339-5759 2014-04-10
1790086668 Dentistry for Children of Georgia LLC Dentist 1350 Spring St Nw Ste 600, Atlanta, GA 30309-2870 2010-11-09
1003123563 Perimeter Pediatric Dentistry PC Dentist 2221 Johnson Ferry Rd Ne, Ste 2-a, Atlanta, GA 30319-2203 2010-09-07
1497905681 David Michael Treff Dentist 4536 Chamblee Dunwoody Rd Ste 211, Atlanta, GA 30338-6201 2008-09-24
1780888693 Teresa Danielle Jordan Dentist 2646 Gresham Rd Se, Atlanta, GA 30316-4148 2007-06-13
1659413953 Ezat Mulki Dentist 1350 Spring St Nw, Ste 600, Atlanta, GA 30309-2864 2007-02-13
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Competitor

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City ATLANTA
Zip Code 30342

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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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