LIFETIME DENTAL GROUP LLC (NPI# 1922380633) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1922380633 |
Entity Type | Organization |
Organization Name | LIFETIME DENTAL GROUP LLC |
Other Organization Name | GWINNETT PLACE DENTAL |
Practice Address |
3796 Satellite Blvd Duluth GA 30096-5699 |
Mailing Address |
3920 Shiloh Ridge Run Suwanee GA 30024-6015 |
Practice Telephone | 7704764140 |
Practice Fax Number | 7704979435 |
Enumeration Date | 2011-09-20 |
Last Update Date | 2011-09-20 |
Authorized Official Name | DR. FABIOLA PALACIOS-BARRIONUEVO (MEMBER) |
Authorized Official Telephone | 7708424900 |
Authorized Official Credential | DDS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223G0001X |
Dentist Specialization: General Practice |
DN014333 | GA | Dental Providers |
Other Name | Type Code |
---|---|
Gwinnett Place Dental | Doing Business As Name - Organization |
Street Address |
3796 SATELLITE BLVD |
City | DULUTH |
State | GA |
Zip Code | 30096-5699 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124172614 | Christopher B Wright | Dentist | 3796 Satellite Blvd, Suite 201, Duluth, GA 30096-5699 | 2007-01-22 |
1699325506 | Dental Home Atlanta | Dentist | 3796 Satellite Blvd, Suite #100, Duluth, GA 30096 | 2019-09-13 |
1609230143 | Duluth Pediatric Dentistry PC | Dentist | 3796 Satellite Blvd, Suite 201, Duluth, GA 30096-5699 | 2016-04-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922615897 | Georgia Eye Optical, LLC | Ophthalmology | 3800 Pleasant Hill Rd Ste 3, Duluth, GA 30096 | 2020-09-25 |
1568090868 | Positive Behavior Services, Inc | Behavior Technician | 3765 Crestwood Pkwy Nw, Duluth, GA 30096 | 2020-03-31 |
1861031940 | Elizabeth Ashley Edouard | Counselor | 3464 Duluth Hwy 120, Duluth, GA 30096 | 2020-01-06 |
1245701044 | Kathryn Irene Vaughn | Social Worker | 3968 Mainsail Court, Duluth, GA 30096 | 2018-12-06 |
1083184626 | Aica Orthopedics, P.C. | Orthopaedic Surgery | 3775 Venture Drive Bldg F, Duluth, GA 30096 | 2018-11-27 |
1245709799 | Positive Impact Health Centers, Inc. | Pharmacy | 3350 Breckinridge Blvd, Suite 200a, Duluth, GA 30096 | 2018-11-14 |
1235611724 | Katherine Winstead Knott | Counselor | 3460 Summit Ridge Parkway, Suite 503, Duluth, GA 30096 | 2018-08-31 |
1710467857 | Envision Optics LLC | Optometrist | 1943 Pleasant Hill Rd, Duluth, GA 30096 | 2018-08-17 |
1104314202 | Erin Mckernan Scupham | Chiropractor | 3820 Pleasant Hill Rd. Ne, Suite 4, Duluth, GA 30096 | 2018-04-25 |
1053839456 | Rogers Bridge Pediatric Therapy, LLC | Clinic/Center | 2845 Summercrest Ln, Duluth, GA 30096 | 2017-09-06 |
Find all providers in zip 30096 |
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 |
---|---|---|---|---|
1023677275 | Gabrielle Lina Going | Dentist | 2405 Satellite Blvd Ste 115, Duluth, GA 30096-9022 | 2019-06-11 |
1093296733 | Marharyta Viarkhouskaya | Dentist | 2550 Pleasant Hill Rd Ste 119, Duluth, GA 30096-9278 | 2018-08-21 |
1881114015 | Eric Michael Anderson | Dentist | 2925 Premiere Pkwy Ste 165, Duluth, GA 30097-5258 | 2017-06-20 |
1790213825 | Devan Callaway | Dentist | 3415 Highway 120, Duluth, GA 30096-3354 | 2017-06-02 |
1184161119 | George Marius Dinulescu | Dentist | 3780 Old Norcross Rd Ste 303, Duluth, GA 30096-1742 | 2017-01-29 |
1801260187 | Bluestone Dental Pllc | Dentist | 906 Woodland Avenue, Duluth, MN 55812-1113 | 2015-11-24 |
1144600859 | Camille Zelen Dds Pa | Dentist | 1624 Woodland Ave, Duluth, MN 55803-2628 | 2015-06-08 |
1205230976 | Ace Dental Care, LLC | Dentist | 7990 Turnberry Way, Duluth, GA 30097-1634 | 2014-10-09 |
1588904619 | Janet Stuckwish Dunwody | Dentist | 3677 Habersham Ln, Duluth, GA 30096-6111 | 2013-02-27 |
1124305057 | Jong S Lee | Dentist | 4855 River Green Pkwy Ste 110, Duluth, GA 30096-8333 | 2011-11-06 |
Find all providers in DULUTH |
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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.