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).
| 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 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
011647 | GA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | AVESIS | 100864 | 01 |
| GA | DORAL | 9182400 | 01 |
| Street Address |
5455 MERIDIAN MARK RD SUITE 200 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30342 |
| 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 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 30342 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| Find all providers in ATLANTA | ||||
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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.