DENTISTRY AT HICKORY FLAT PC (NPI# 1437573748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437573748 |
| Entity Type | Organization |
| Organization Name | DENTISTRY AT HICKORY FLAT PC |
| Other Organization Name | DENTISTRY AT HICKORY FLAT |
| Practice Address |
6199 Hickory Flat Hwy Ste 130 Canton GA 30115-7255 |
| Practice Telephone | 7702138166 |
| Practice Fax Number | 7702138157 |
| Mailing Telephone | 7702138166 |
| Mailing Fax Number | 7702138157 |
| Enumeration Date | 2014-02-06 |
| Last Update Date | 2015-05-18 |
| Authorized Official Name | BRIAN Y LEE (DENTIST/OWNER) |
| Authorized Official Telephone | 7702138166 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QD0000X |
Clinic/Center Specialization: Dental |
DN013420 | GA | Ambulatory Health Care Facilities |
| N | 261QD0000X |
Clinic/Center Specialization: Dental |
DN013473 | GA | Ambulatory Health Care Facilities |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| DENTISTRY AT HICKORY FLAT | Doing Business As Name - Organization |
| Street Address |
6199 HICKORY FLAT HWY STE 130 |
| City | CANTON |
| State | GA |
| Zip Code | 30115-7255 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497364806 | Amanda Arbogast | Speech-Language Pathologist | 610 Royal Crest Court, Canton, GA 30115 | 2020-07-31 |
| 1033754163 | Kelly Marie Shirley | Nurse Practitioner | 450 Northside Cherokee Blvd., Radiology Dept., Canton, GA 30115 | 2019-11-13 |
| 1700394319 | Jennifer Lynn Davenport | Nurse Practitioner | 684 Sixes Rd Ste 125, Holly Springs, GA 30115 | 2018-01-17 |
| 1851717961 | Wal-mart Stores East, Lp | Technician/Technologist | 2200 Holly Springs Pkey, Holly Springs, GA 30115 | 2014-03-13 |
| 1194148502 | Julia Bedingfield Reid | Pharmacist | 450 Northside Cherokee Blvd Ste T20, Canton, GA 30115 | 2014-01-22 |
| 1447597992 | America's Best Contacts & Eyeglasses | Technician/Technologist | 2030 Cumming Highway, Suite 106, Canton, GA 30115 | 2013-01-03 |
| 1679821193 | Jill M Decorso | Speech-Language Pathologist | 4280 Hickory Flat Hwy, Ste 108, Canton, GA 30115 | 2012-08-15 |
| 1306113378 | Sidney Boyd Collier IIi | Pharmacist | 6111 Hickory Flat Highway, Canton, GA 30115 | 2011-11-18 |
| 1174804702 | Rayllensons Itacy | Physician Assistant | 2020 Cumming Highway, Suite 102, Canton, GA 30115 | 2011-09-09 |
| 1245534346 | Kim M. Mcmillan | Counselor | 154 Lakeside Drive, Canton, GA 30115 | 2011-01-04 |
| Find all providers in zip 30115 | ||||
| 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 |
|---|---|---|---|---|
| 1760008361 | Portable Smiles Mobile Inc | Dentist | 519 Pinehurst Dr, Canton, MI 48188-3078 | 2020-06-19 |
| 1740825207 | Vlp Can LLC | Dentist | 39883 Ford Rd., Canton, MI 48187 | 2019-11-08 |
| 1669014403 | Flossed LLC | Dentist | 500 Chapman St Unit 201, Canton, MA 02021-2040 | 2019-10-14 |
| 1164078960 | Caleb Jonathon Fuller | Dentist | 46592 W Oak Manor Ct, Canton, MI 48187-5230 | 2019-08-16 |
| 1518527191 | Pediatric Dentistry | Dentist | 45535 Hanford Rd, Canton, MI 48187-4595 | 2019-06-17 |
| 1710546148 | Georgia Dental Professionals, PC | Dentist | 8022 Cumming Hwy, Canton, GA 30115-9337 | 2019-06-10 |
| 1891267316 | Canton Marketplace Dentistry LLC | Dentist | 1810 Cumming Hwy Ste 900, Canton, GA 30115-2999 | 2018-12-21 |
| 1548754252 | Ashvi Mittal | Dentist | 248 Taylors Farm Dr, Canton, GA 30115-9023 | 2018-06-15 |
| 1285127605 | Cameron Parker Demarsh | Dentist | 2414 Whipple Ave Nw, Canton, OH 44708-1514 | 2018-06-11 |
| 1184146318 | Cherokee Family Dental East Cherokee LLC | Dentist | 7768 Cumming Hwy Ste 100, Canton, GA 30115-2982 | 2017-07-10 |
| Find all providers in CANTON | ||||
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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.