LITTLE PEACHES PEDIATRIC DENTISTRY (NPI# 1801246079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801246079 |
| Entity Type | Organization |
| Organization Name | LITTLE PEACHES PEDIATRIC DENTISTRY |
| Practice Address |
120 Handley Rd Suite 210 Tyrone GA 30290-2177 |
| Practice Telephone | 7706327090 |
| Practice Fax Number | 7706327075 |
| Mailing Telephone | 7706327090 |
| Mailing Fax Number | 7706327075 |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2016-06-17 |
| Authorized Official Name | DR. CHARISSE CASWELL (OWNER) |
| Authorized Official Telephone | 7706327090 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DN013163 | GA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 773054619G | 05 | |
| GA | 773054619H | 05 |
| Street Address |
120 HANDLEY RD SUITE 210 |
| City | TYRONE |
| State | GA |
| Zip Code | 30290-2177 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720070501 | Suvrat Jagannivas Bhargave | Specialist | 120 Handley Rd, Suite 310, Tyrone, GA 30290-2177 | 2005-08-18 |
| 1043612922 | Hdh Healthcare Group, LLC | Internal Medicine | 120 Handley Rd, #400, Tyrone, GA 30290-2177 | 2014-09-22 |
| 1407124043 | Mary Ann Navarre | Counselor | 120 Handley Rd, Tyrone, GA 30290-2177 | 2011-12-11 |
| 1730466780 | Jennifer Wallace Merrill | Counselor | 120 Handley Rd, Tyrone, GA 30290-2177 | 2011-11-04 |
| 1932359627 | Durden Chiropractic Clinic, Inc. | Chiropractor | 120 Handley Rd, Suite 220, Tyrone, GA 30290-2177 | 2008-09-30 |
| 1407973936 | Genesys Family Practice, Inc. | Family Medicine | 120 Handley Rd, Suite 410, Tyrone, GA 30290 | 2007-03-22 |
| 1952433864 | Suvrat J Bhargave Md PC | Physician Assistant | 120 Handley Rd, Suite 310, Tyrone, GA 30290-2177 | 2007-03-09 |
| 1972671634 | Cynthia A Duncan | Clinical Nurse Specialist | 120 Handley Rd, Tyrone, GA 30290-2177 | 2006-12-01 |
| 1841379740 | Center for Family Psychiatry | Counselor | 120 Handley Rd, Suite 310, Tyrone, GA 30290-2177 | 2006-11-03 |
| 1831274752 | Marilyn L Durden | Chiropractor | 120 Handley Rd, Suite 220, Tyrone, GA 30290-2177 | 2006-10-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407215361 | Kaitlin Lackey | Occupational Therapist | 105 Glendalough Court, Suite H, Tyrone, GA 30290 | 2016-02-19 |
| 1114211745 | Johannes Daniel Smit | Pharmacist | 525 Valleywood Drive, Tyrone, GA 30290 | 2011-05-31 |
| 1760700199 | Georgia Integrative Medicine | Preventive Medicine | 120 Milbrook Village Drive, Suite E, Tyrone, GA 30290 | 2010-05-10 |
| 1427384783 | Exelle Home Care | Home Health | 105 Silverthorn Drive, Tyrone, GA 30290 | 2009-10-21 |
| 1386884138 | Genesys Ob/gyn, LLC | Clinic/Center | 245 Greencastle Road, Tyrone, GA 30290 | 2009-03-05 |
| 1689858805 | Immediate Care Centers of Georgia, LLC | Clinic/Center | 190 Greencastle Rd., Tyrone, GA 30290 | 2007-12-24 |
| 1437212834 | Dawn M Coffman | Physician Assistant | 190 Handley Rd., Tyrone, GA 30290 | 2006-12-18 |
| 1912971805 | Jason Rex Lee | Dentist | 195 Greencastle Rd, Tyrone, GA 30290 | 2006-02-15 |
| 1053898759 | Heather Renee Ellis | Physical Therapist | 62 Carriage Oaks Dr, Tyrone, GA 30290 | 2018-07-25 |
| 1134630858 | Marjorie Yvette Elibert | Advanced Practice Midwife | 190 Handley Rd Ste A, Tyrone, GA 30290 | 2017-10-20 |
| Find all providers in zip 30290 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851507271 | Gary Lee Kistner | Dentist | 2 Hospital Dr, Tyrone, PA 16686-1805 | 2007-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740895002 | Ashley Starnesdmd LLC | Dentist | 5482 Chamblee Dunwoody Rd Ste 9, Dunwoody, GA 30338-4142 | 2020-09-14 |
| 1912518531 | Samuel S Kwon - Athens Dmd PC | Dentist | 1795 Resurgence Drive, Suite 101, Watkinsville, GA 30677 | 2020-08-17 |
| 1366060618 | A Dental Home 4 Kidz | Dentist | 155 Carnegie Pl Ste 201, Fayetteville, GA 30214-3981 | 2020-07-13 |
| 1255973566 | Rehoboth Life Care Ministries, Inc | Dentist | 3208 Hwy 41, Byron, Byron, GA 31008 | 2019-10-09 |
| 1629619200 | Peachtree Hills Pediatric Dentistry | Dentist | 2385 Peachtree Rd Ne Ste A2ab, Atlanta, GA 30305-4139 | 2019-10-04 |
| 1871145557 | Dogwood Pediatric Dentistry of Statesboro, LLC | Dentist | 123 Hill Pond Ln, Statesboro, GA 30458-0872 | 2019-07-12 |
| 1952969396 | Ns3 Services, LLC | Dentist | 1039 Grant St Se Ste B11, Atlanta, GA 30315-2050 | 2019-05-31 |
| 1871050872 | Warner Robins Pediatric Dentistry LLC | Dentist | 102 S Houston Rd, Warner Robins, GA 31088-3904 | 2019-02-26 |
| 1730646886 | Smiles for Kids Norcross PC | Dentist | 3953 Holcomb Bridge Rd Ste 100, Peachtree Corners, GA 30092-5201 | 2019-02-25 |
| 1073083127 | Pediatric Dentistry of Central Georgia - Macon LLC | Dentist | 5437 Bowman Rd Ste 300, Macon, GA 31210-6575 | 2018-12-03 |
| 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.