PROFESSIONAL DENTAL ALLIANCE OF COVINGTON, LLC (NPI# 1629537626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629537626 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL DENTAL ALLIANCE OF COVINGTON, LLC |
| Practice Address |
9164 Dr M L King Jr Ave Covington GA 30014-8710 |
| Mailing Address |
11 S Mill St Ste 200 New Castle PA 16101-3680 |
| Practice Telephone | 7707847030 |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2019-03-19 |
| Authorized Official Name | LAUREN HOWARD (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 7246982029 |
| Authorized Official Credential | MA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| Street Address |
9164 DR M L KING JR AVE |
| City | COVINGTON |
| State | GA |
| Zip Code | 30014-8710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770078503 | Michael Benjamin Hampton | Dentist | 9164 Dr M L King Jr Ave, Covington, GA 30014-8710 | 2018-06-25 |
| 1881259109 | Travis E Hampton, Dmd, PC | Dentist | 9164 Dr M L King Jr Ave, Covington, GA 30014-8710 | 2019-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801495635 | Cathy Cassandra Collins | Pharmacist | 3639 Hwy 278, Covington, GA 30014 | 2020-10-22 |
| 1154933877 | Atl Optical LLC | Optometrist | 3135 Highway 278 Ne, Covington, GA 30014 | 2020-08-24 |
| 1932737046 | Samagas House Org | Adult Companion | 1500 Mountain View Cirlcle, Conyers, GA 30014 | 2020-04-01 |
| 1356834360 | Covington Dental Care | Dentist | 4139 Baker Street, Suite 15, Covington, GA 30014 | 2018-06-13 |
| 1487190005 | New Avenues Assessment and Counseling Center LLC | Counselor | 3192 Spring Street, Covington, NEWTON 30014 | 2017-01-07 |
| 1275903973 | Jennifer Carol Bridges | Registered Nurse | 320 Malcom Lane, Covington, GA 30014 | 2015-10-07 |
| 1134598501 | Shelby Boggus King | Physician Assistant | 4181 Hospital Drive Ne, Suite 204, Covington, GA 30014 | 2015-09-16 |
| 1366829814 | Wendy Pazdur | Counselor | 5109 Hwy 278 East, Suite D, Covington, GA 30014 | 2015-05-05 |
| 1306235445 | Covington Center for Family Dentistry | Dentist | 10373 Industrial Blvd, Covington, GA 30014 | 2015-01-13 |
| 1992103428 | Modern Cosmetic Dental Care, LLC | Clinic/Center | 1750 Highway 11, Suite B, Covington, GA 30014 | 2014-12-16 |
| Find all providers in zip 30014 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124510276 | Washington Dental Corporation, PC | Dentist | 27237 172nd Ave Se Ste 105a, Covington, WA 98042-7352 | 2018-06-05 |
| 1144732223 | Cali Nicole Spell | Dentist | 79132 Highway 40, Covington, LA 70435-9329 | 2017-10-30 |
| 1346693892 | Kyle Blair | Dentist | 17121 Se 270th Pl Ste 202, Covington, WA 98042-5431 | 2016-07-20 |
| 1134570591 | Dr. Bill Gramzinski, D.m.d., P.C. | Dentist | 3204 Mill St Ne, Covington, GA 30014-2538 | 2016-06-28 |
| 1083062228 | Solomon Yakubov | Dentist | 4139 Baker Street, Suite 15, Covington, GA 30014-3001 | 2016-05-27 |
| 1306235445 | Covington Center for Family Dentistry | Dentist | 10373 Industrial Blvd, Covington, GA 30014 | 2015-01-13 |
| 1346655453 | Timothy Reid Miller | Dentist | 27081 185th Ave Se Ste 105, Covington, WA 98042-8448 | 2014-06-26 |
| 1245676568 | Magnolia Dental LLC | Dentist | 6061 Pinnacle Parkway, Covington, LA 70433 | 2013-05-14 |
| 1861738973 | Covington Family Dentistry LLC | Dentist | 4168 Baker St Ne, Covington, GA 30014-1404 | 2012-12-17 |
| 1982966537 | Charles Zachary Staples | Dentist | 6061 Pinnacle Pkwy, Covington, LA 70433-9193 | 2012-06-11 |
| Find all providers in COVINGTON | ||||
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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.