EASTLIGHT DENTAL, L.L.C. (NPI# 1689152282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689152282 |
| Entity Type | Organization |
| Organization Name | EASTLIGHT DENTAL, L.L.C. |
| Practice Address |
2536 Rockbridge Rd Ste 103 Stone Mountain GA 30087-3636 |
| Practice Telephone | 6783955913 |
| Mailing Telephone | 6783955913 |
| Mailing Fax Number | 6783955678 |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2018-09-18 |
| Authorized Official Name | MR. EDMUND THOMAS JR. (OWNER) |
| Authorized Official Telephone | 7169492183 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
2536 ROCKBRIDGE RD STE 103 |
| City | STONE MOUNTAIN |
| State | GA |
| Zip Code | 30087-3636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578979381 | Edmund Thomas Jr. | Dentist | 2536 Rockbridge Rd Ste 103, Stone Mountain, GA 30087 | 2014-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477176394 | Optimal Choice Telehealth | General Practice | 1227 Rockbidge Rd Sw, Ste 208-354, Stone Mountain, GA 30087 | 2020-05-27 |
| 1245882943 | Lynell Williams | Counselor | 505 Lilburn-stone Mountain Road, Suite 235, Stone Mountain, GA 30087 | 2019-07-12 |
| 1003302688 | Mark Andrew Stevens | Physical Therapist | 1227 Rockbridge Rd Ste 402, Stone Mountain, GA 30087 | 2018-07-06 |
| 1154816825 | Tuan Minh Khong | Physician Assistant | 6301 Southland Rdg, Stone Mountain, GA 30087 | 2018-06-26 |
| 1215429881 | Stephanie Martin | Nurse Practitioner | 2720 S Rockbridge Rd, Stone Mountain, GA 30087 | 2018-05-30 |
| 1790027688 | Robert Fanning Eaves Jr. | General Practice | 5394 Leatherstocking Lane, Stone Mountain, GA 30087 | 2013-03-19 |
| 1609128917 | Mary Marlene Muse | Lactation Consultant, Non-RN | 510 Navarre Drive, Stone Mountain, GA 30087 | 2012-10-10 |
| 1457680704 | Cleo Evans | Counselor | 5638 Manassas Run, Stone Mountain, GA 30087 | 2009-12-16 |
| 1932348521 | Lawrence Randy Sheber | Dentist | 5500-a Lilburn Stone Mountain Road, Stone Mountain, GA 30087 | 2009-02-05 |
| 1730348210 | Childrens Dentistry of Lithonia LLC | Clinic/Center | 374 C North Deshon Road, Stone Mountain, GA 30087 | 2008-06-09 |
| Find all providers in zip 30087 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366953929 | Excellent Dental Providers, PC | Clinic/Center | 1001 Main St Ste F, Stone Mountain, GA 30083-2922 | 2017-10-22 |
| 1639689011 | Veer LLC | Clinic/Center | 5468 Memorial Dr Ste A, Stone Mountain, GA 30083-3267 | 2017-10-11 |
| 1730348210 | Childrens Dentistry of Lithonia LLC | Clinic/Center | 374 C North Deshon Road, Stone Mountain, GA 30087 | 2008-06-09 |
| 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 | ||||
| City | STONE MOUNTAIN |
| Zip Code | 30087 |
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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.