WESTSIDE DENTAL (NPI# 1649486028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649486028 |
| Entity Type | Organization |
| Organization Name | WESTSIDE DENTAL |
| Practice Address |
3515 Dallas Hwy Sw Ste B Marietta GA 30064-1613 |
| Practice Telephone | 7704997005 |
| Practice Fax Number | 7704997081 |
| Mailing Telephone | 7704997005 |
| Mailing Fax Number | 7704997081 |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. GEORGE NEAL GOOLSBY (OWNER) |
| Authorized Official Telephone | 7704997005 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 8787 | GA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558507731 | Westside Dental | Dentist | 1460 W Main St, Sun Prairie, WI 53590-1846 | 2008-12-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | WESTSIDE DENTAL | 8285 Sw Nimbus Ave #185, Beaverton, OR 97008 |
| Oregon Corporations, Companies and Business Names | WESTSIDE DENTAL CLINIC LLC | 6505 Se Stark St, Portland, OR 97215 |
| Oregon Corporations, Companies and Business Names | WESTSIDE DENTAL GROUP BUILDING, LLC | 1552 River Loop 1, Eugene, OR 97404 |
| Oregon Corporations, Companies and Business Names | WESTSIDE DENTAL, P.C. | 4150 Sw 110th Ave, Beaverton, OR 97005 |
| Street Address |
3515 DALLAS HWY SW STE B |
| City | MARIETTA |
| State | GA |
| Zip Code | 30064-1613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891771366 | Stephen B Wilson | Dentist | 3515 Dallas Hwy Sw Ste B, Marietta, GA 30064-2095 | 2005-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043833304 | Chelsey Lewis | Pharmacist | 660 Whitlock Ave Sw, Marietta, GA 30064 | 2020-05-21 |
| 1316428527 | Candice Murray | Nurse Practitioner | 2727 Wynford Ave Sw, Marietta, GA 30064 | 2018-08-25 |
| 1427539741 | Emily Dorsey Drew | Nurse Practitioner | 3911 Mary Eliza Trce Nw Ste 200, Marietta, GA 30064 | 2018-08-24 |
| 1649765017 | Julie K Berger | Counselor | 336 Powder Springs St Suite 206, Marietta, GA 30064 | 2018-06-27 |
| 1689175291 | Anthony Bammer | Clinical Exercise Physiologist | 1001 Whitlock Avenue Nw, Marietta, GA 30064 | 2018-02-28 |
| 1831600725 | Dyniecia Barnes | Specialist | 2575 White Haven Dr Sw, Ste 100 / Salon 121, Marietta, GA 30064 | 2017-10-18 |
| 1588173298 | Michelle Ann Stich | Assistant Behavior Analyst | 376 Powder Springs St Ste 130, Marietta, GA 30064 | 2017-09-26 |
| 1194241976 | Namasine Lolice Dalrymple | Counselor | 1708 Peachtree St, Suite 300, Atlanta, GA 30064 | 2017-08-14 |
| 1245760859 | Michael H Mulkey, Dmd PC | Dentist | 3951 Mary Eliza Trace Nw, Suite 200, Marietta, GA 30064 | 2017-06-15 |
| 1700310893 | West Cobb Dentist Office, PC | Dentist | 3805 Dallas Hwy Sw, Suite 804, Marietta, GA 30064 | 2017-04-14 |
| Find all providers in zip 30064 | ||||
| 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 |
|---|---|---|---|---|
| 1538714639 | Dionne Joi Wells | Dentist | 3805 Dallas Hwy Sw Ste 806, Marietta, GA 30064-1620 | 2019-08-06 |
| 1346736931 | Graham A Kellams | Dentist | 2655 Dallas Hwy Sw Ste 510, Marietta, GA 30064-7520 | 2018-07-06 |
| 1972090504 | Waldron and Lee Dentistry LLC | Dentist | 3020 Roswell Rd Ste 100, Marietta, GA 30062-4987 | 2018-04-19 |
| 1245750165 | Paul Douglas Martin | Dentist | 270 Cobb Pkwy S Ste 180, Marietta, GA 30060-6520 | 2017-06-21 |
| 1700310893 | West Cobb Dentist Office, PC | Dentist | 3805 Dallas Hwy Sw, Suite 804, Marietta, GA 30064 | 2017-04-14 |
| 1225577737 | Holly Markwordt | Dentist | 1136 Taliwa Trl Ne, Marietta, GA 30068-2389 | 2017-02-16 |
| 1578000444 | Engineered Smiles, LLC | Dentist | 670 Johnson Ferry Rd, Marietta, GA 30068-4627 | 2017-01-30 |
| 1194260679 | Sage Dental Group of Georgia LLC | Dentist | 4811 Lower Roswell Rd, Suite 108, Marietta, GA 30068-4372 | 2016-12-20 |
| 1396103537 | Hira Rana | Dentist | 1721 Powder Springs Rd Sw, Suite 103, Marietta, GA 30064-4879 | 2016-02-02 |
| 1437535325 | Daniel Van Galder | Dentist | 361 N Marietta Pkwy Ne, Marietta, GA 30060-1545 | 2015-08-03 |
| Find all providers in MARIETTA | ||||
Please comment or provide details below to improve the information on WESTSIDE DENTAL.
| 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.