QUITMAN FAMILY DENTISTRY LLC (NPI# 1639426836) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639426836 |
| Entity Type | Organization |
| Organization Name | QUITMAN FAMILY DENTISTRY LLC |
| Practice Address |
1306 E. Screven Street Quitman GA 31634 |
| Practice Telephone | 2292638700 |
| Mailing Telephone | 2292638700 |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2012-08-07 |
| Authorized Official Name | DR. LARRY M BLACK JR. (OWNER) |
| Authorized Official Telephone | 2292638700 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QD0000X |
Clinic/Center Specialization: Dental |
DNSC000233 | GA | Ambulatory Health Care Facilities |
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
DN012932 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003124373A | 05 |
| Street Address |
1306 E. SCREVEN STREET |
| City | QUITMAN |
| State | GA |
| Zip Code | 31634 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467976159 | Joy Sumner | Contractor | 191 Court Street, Homerville, GA 31634 | 2017-08-03 |
| 1912241720 | Pratyusha Chetan Patel | Pharmacist | 191 North Church Street, Riteaid Pharmacy, Homerville, GA 31634 | 2012-11-16 |
| 1154467470 | Unison Behavioral Health | Day Training, Developmentally Disabled Services | 551 Old Pearson Road, Pearson, GA 31634 | 2007-01-30 |
| 1295894509 | Shannon Davis Smith | Chiropractor | 235 North Church Street, Homerville, GA 31634 | 2006-12-06 |
| 1174595722 | Lynn Fletcher | Nurse Practitioner | 80 Huxford St, Homerville, GA 31634 | 2006-02-07 |
| 1114910429 | Heather Marie Moss | Physician Assistant | Clinch Memorial Hospital, 1050 Valdosta Hwy, Homerville, GA 31634 | 2005-08-23 |
| 1790223667 | Igor Ancor | Internal Medicine | 80 Huxford St, Homerville, GA 31634 | 2017-02-10 |
| 1063961522 | Betsy Daugharty Clifton | Nurse Practitioner | 180 Carswell St, Homerville, GA 31634 | 2016-09-26 |
| 1861856486 | Golden Isles Chiropractic | Point of Service | 62 Lisa Rd, Homerville, GA 31634-1513 | 2016-04-09 |
| 1427368539 | Unison Behavioral Health | Counselor | 551 Old Pearson Rd, Homerville, GA 31634-1724 | 2010-10-08 |
| Find all providers in zip 31634 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578626966 | Donald G. Traxler, D.m.d., P.a. | Clinic/Center | 303a S Archusa Ave, Quitman, MS 39355-2325 | 2006-12-18 |
| 1972073849 | Michael W Hubbert Dmd, LLC | Clinic/Center | 99 Highway 511, Quitman, MS 39355-8899 | 2018-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922606490 | Smile Pleasant Hill LLC | Clinic/Center | 828 Pleasant Hill Rd Nw Ste 10, Lilburn, GA 30047-2757 | 2020-10-15 |
| 1982213583 | Munoz Dental Resources LLC | Clinic/Center | 4141 Steve Reynolds Blvd Ste 1, Norcross, GA 30093-3060 | 2020-07-29 |
| 1407474794 | Familia Dentistry of Georgia, LLC | Clinic/Center | 4574 Lawrenceville Hwy Nw Ste 120r, Lilburn, GA 30047-3605 | 2020-07-13 |
| 1336763648 | Bethlehem Orthodontics | Clinic/Center | 426 Exchange Blvd Ste 400, Bethlehem, GA 30620-1791 | 2020-06-02 |
| 1770106882 | Smiles By Dixon PC | Clinic/Center | 690 Lanier Park Dr, Gainesville, GA 30501-2061 | 2020-05-22 |
| 1811516479 | Mouthpeace Dental 4, LLC | Clinic/Center | 541 Forest Pkwy Ste 18, Forest Park, GA 30297-6110 | 2020-04-14 |
| 1427677541 | Mh Dental Group, LLC | Clinic/Center | 1305 Cedarcrest Rd Ste 115, Dallas, GA 30132-8201 | 2020-04-09 |
| 1104451160 | Sno Healthcare Group | Clinic/Center | 2424 Roswell Rd Ste 120, Marietta, GA 30062 | 2020-03-10 |
| 1952935710 | West Cobb Periodontics and Implant Dentistry LLC | Clinic/Center | 44 Old Hamilton Rd Nw Ste 200, Marietta, GA 30064-5901 | 2020-03-02 |
| 1659904241 | Dental Now Kids LLC | Clinic/Center | 4151 Steve Reynolds Blvd Ste 2, Norcross, GA 30093-3060 | 2020-02-21 |
| Find all providers with the same taxonomy | ||||
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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.