GEORGIA DENTAL PROFESSIONALS, PC (NPI# 1780220194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780220194 |
| Entity Type | Organization |
| Organization Name | GEORGIA DENTAL PROFESSIONALS, PC |
| Other Organization Name | DENTAL CARE AT ROSE CREEK |
| Practice Address |
4355 Towne Lake Pkwy Woodstock GA 30189-8150 |
| Practice Telephone | 6789050211 |
| Mailing Telephone | 7706270319 |
| Mailing Fax Number | 7706392464 |
| Enumeration Date | 2019-11-20 |
| Last Update Date | 2020-03-11 |
| Authorized Official Name | JESSICA BRITT (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 2175405100 |
| Is Organization Subpart | Y |
| Parent Organization Name | GEORGIA DENTAL PROFESSIONALS, PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Dental Care at Rose Creek | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760098214 | Georgia Dental Professionals, PC | Dentist | 3000 Chapel Hill Rd Ste 104, Douglasville, GA 30135-1841 | 2020-09-21 |
| 1063028769 | Georgia Dental Professionals, PC | Dentist | 3364 Hamilton Mill Rd, Buford, GA 30519-4005 | 2020-09-17 |
| 1306452016 | Georgia Dental Professionals, PC | Dentist | 2680 Highway 34 E Ste A, Newnan, GA 30265-1330 | 2020-09-17 |
| 1720693690 | Georgia Dental Professionals, PC | Dentist | 3625 Browns Bridge Rd Ste 101, Cumming, GA 30028-4198 | 2020-09-09 |
| 1285242693 | Georgia Dental Professionals, PC | Dentist | 5185 Peachtree Pkwy Ste 201, Norcross, GA 30092-6539 | 2020-07-22 |
| 1831746999 | Georgia Dental Professionals, PC | Dentist | 1207 Highway 74 S, Peachtree City, GA 30269-3078 | 2019-08-23 |
| 1972165207 | Georgia Dental Professionals, PC | Dentist | 516 Ga Highway 247 S, Bonaire, GA 31005-3865 | 2019-07-08 |
| 1710546148 | Georgia Dental Professionals, PC | Dentist | 8022 Cumming Hwy, Canton, GA 30115-9337 | 2019-06-10 |
| 1730747528 | Georgia Dental Professionals, PC | Dentist | 920 Loganville Hwy Ste 100, Bethlehem, GA 30620 | 2019-06-05 |
| 1417422007 | Georgia Dental Professionals, PC | Dentist | 6759 Hickory Rd, Woodstock, GA 30188-2019 | 2018-10-10 |
| Street Address |
4355 TOWNE LAKE PKWY |
| City | WOODSTOCK |
| State | GA |
| Zip Code | 30189-8150 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801494356 | Susan Iruku | Pharmacist | 12050 Ga-92 #112, Woodstock, GA 30189 | 2020-10-15 |
| 1598267437 | Kelly Sierra | Nurse Practitioner | 100 Stoneforest Dr Ste 300, Woodstock, GA 30189 | 2018-03-07 |
| 1548770449 | Chandra Johnson | Nurse Practitioner | 295 Molly Lane Ste 150, Woodstock, GA 30189 | 2017-10-05 |
| 1083133912 | Amanda Bostock Sowisdral | Physician Assistant | 250 Parkbrooke Pl Ste 300, Woodstock, GA 30189 | 2017-09-12 |
| 1780101659 | Laura C Koch Woodstock LLC Dba Fountain View Dentistry | Dentist | 1816 Eagle Drive, Building 200-a, Woodstock, GA 30189 | 2017-08-23 |
| 1265954788 | Vicky Morton Bryan | Nurse Practitioner | 422 Sycamore Trail, Woodstock, GA 30189 | 2017-07-17 |
| 1063933588 | Marietta Eye Clinic, Pa | Optometrist | 2990 Eagle Dr Ste 110, Woodstock, GA 30189 | 2017-07-06 |
| 1275914749 | Nrup Tolat | Podiatrist | 100 Stoneforest Dr Ste 120, Woodstock, GA 30189 | 2015-06-10 |
| 1558781534 | Mary Jansson Carmon | Nurse Practitioner | 1000 Towne Lake Pkwy, Woodstock, GA 30189 | 2014-04-17 |
| 1518388941 | Afc Physicians of Georgia, PC | General Practice | 6440 Bells Ferry Rd, Woodstock, GA 30189 | 2014-01-03 |
| Find all providers in zip 30189 | ||||
| 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 |
|---|---|---|---|---|
| 1417422007 | Georgia Dental Professionals, PC | Dentist | 6759 Hickory Rd, Woodstock, GA 30188-2019 | 2018-10-10 |
| 1083197453 | Abb Dental Group LLC | Dentist | 11585 Us 14, Woodstock, IL 60098 | 2018-09-12 |
| 1780101659 | Laura C Koch Woodstock LLC Dba Fountain View Dentistry | Dentist | 1816 Eagle Drive, Building 200-a, Woodstock, GA 30189 | 2017-08-23 |
| 1578090056 | Woodstock Dentistry, PC | Dentist | 1428 Towne Lake Pkwy Ste 99, Woodstock, GA 30189-8265 | 2017-05-16 |
| 1871026724 | Bo Yeon Bartilotta | Dentist | 11585 Us-14, Woodstock, IL 60098 | 2017-04-07 |
| 1972985794 | David Haithcock | Dentist | 6304 Old Highway 5 Ste 100, Woodstock, GA 30188-2500 | 2015-06-29 |
| 1336552173 | Robert Clayton Cannon | Dentist | 8950 Main Street, Suite 120, Woodstock, GA 30188 | 2014-06-10 |
| 1669721783 | Robert Eugene Haraden | Dentist | 651 S. Eastwood Dr, Woodstock, IL 60098 | 2012-09-05 |
| 1942557004 | Sang-do David Lee | Dentist | 651 S. Eastwood Dr., Woodstock, IL 60098 | 2012-08-08 |
| 1255663555 | Laura S Hernandez-dauer | Dentist | 130 East Reservoir Road, Woodstock, VA 22664 | 2010-02-11 |
| Find all providers in WOODSTOCK | ||||
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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.