FABULOUS SMILES OF ATLANTA LLC (NPI# 1962660555) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962660555 |
| Entity Type | Organization |
| Organization Name | FABULOUS SMILES OF ATLANTA LLC |
| Practice Address |
1188 Ralph David Abernathy Blvd Sw Suite 101 Atlanta GA 30310-1754 |
| Practice Telephone | 4047580770 |
| Mailing Telephone | 4047580770 |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2008-05-30 |
| Authorized Official Name | DR. DANIELLE DENISE GREENE (PRESIDENT) |
| Authorized Official Telephone | 4047580770 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | 011973 | GA | Managed Care Organizations |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00814965C | 05 |
| Street Address |
1188 RALPH DAVID ABERNATHY BLVD SW SUITE 101 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30310-1754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336234129 | Danielle Greene | Dentist | 1188 Ralph David Abernathy Blvd Sw, Suite 101, Atlanta, GA 30310-1716 | 2006-10-04 |
| 1679889737 | Eric Gerard Lawton Jr. | Dentist | 1188 Ralph David Abernathy Blvd Sw, #101, Atlanta, GA 30310-1716 | 2010-08-27 |
| 1467699629 | University Vision Center LLC | Optometrist | 1188 Ralph David Abernathy Blvd Sw, Suite 110, Atlanta, GA 30310-1716 | 2009-01-09 |
| 1437395522 | Valerie Dianne Robbins-acker | Optometrist | 1188 Ralph David Abernathy Blvd Sw, Suite 110, Atlanta, GA 30310-1716 | 2008-12-19 |
| 1548324361 | Alan K. Cu Chiam Mdpc | Clinic/Center | 1188 Ralph David Abernathy Blvd Sw, Atlanta, GA 30310-1754 | 2006-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134775208 | Naesm Mens Health and Wellness Center | Clinic/Center | 2140 Martin Luther King Jr Dr Sw Ste 201, Atlanta, GA 30310 | 2019-08-14 |
| 1588219810 | Dayana Regis | Pediatrics | 808 York Ave Sw, Atlanta, GA 30310 | 2019-08-04 |
| 1629636683 | Manan Shah | Student in an Organized Health Care Education/Training Program | 720 Westview Dr, Sw Morehouse School of Medicine/gme, Atlanta, GA 30310 | 2019-06-04 |
| 1780242420 | Fortunate Amarachukwu Ejimone | Student in an Organized Health Care Education/Training Program | 720 Westview Dr. Sw Morehouse School of Medicine/gme, Atlanta, GA 30310 | 2019-05-29 |
| 1922589589 | Bria Campbell | Counselor | 1009 Windsor St Sw, Atlanta, GA 30310 | 2018-08-22 |
| 1821583584 | Onyedikachi Kenneth Michaels | Student in an Organized Health Care Education/Training Program | Morehouse School of Medicine / Gme, 720 Westview Dr, Sw, Atlanta, GA 30310 | 2018-06-26 |
| 1881185387 | Precious Oghenefejiro Odunvbun | Student in an Organized Health Care Education/Training Program | 720 West View Dr Sw Morehouse School of Medicine/gme, Department of Medicine, Atlanta, GA 30310 | 2018-05-21 |
| 1598253908 | Chinonyelum Doris Nwagbara | Student in an Organized Health Care Education/Training Program | Morehouse School of Medicine, Gme 720 Westview Drive Sw, Atlanta, GA 30310 | 2018-05-01 |
| 1679060552 | Danielle Nicole Oliver | Student in an Organized Health Care Education/Training Program | Morehouse School of Medicine/gme 720 Westview Dr Sw, Atlanta, GA 30310 | 2018-04-17 |
| 1376049072 | Ngozi Egondu Okanu | Student in an Organized Health Care Education/Training Program | Gme 720 Westview Dr, Sw, Atlanta, GA 30310 | 2018-04-02 |
| Find all providers in zip 30310 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578003349 | Lrdj LLC | Preferred Provider Organization | 790 Huff Rd Nw Apt 4055, Atlanta, GA 30318-4373 | 2017-02-27 |
| 1205288164 | Medprime Brookhaven | Preferred Provider Organization | 2 Concourse Pkwy, Suite 100, Atlanta, GA 30328-5371 | 2016-07-04 |
| 1588052641 | Bjmm Medical LLC | Preferred Provider Organization | 1287 Glenwood Ave Se Ste C, Atlanta, GA 30316-1932 | 2014-12-24 |
| 1982955902 | Melson Counseling & Consulting Group | Preferred Provider Organization | 2900 Chamblee Tucker Rd Bldg 5-300, Atlanta, GA 30341-4158 | 2012-10-01 |
| 1013296078 | Peachtree Spine Center | Preferred Provider Organization | 1401 Peachtree St Ne Ste 160, Atlanta, GA 30309-3000 | 2011-08-09 |
| 1588812465 | Applications Technology Group, Inc. | Preferred Provider Organization | 5825 Glenridge Dr Ne Bldg 3, Atlanta, GA 30328-5387 | 2008-09-04 |
| 1851439830 | Dr.lily Narusevicius | Preferred Provider Organization | 4890 Roswell Rd Ne Ste 100, Atlanta, GA 30342-2606 | 2007-02-02 |
| 1679680557 | Nicholas Jean Beaulieu | Preferred Provider Organization | 920 Ponce De Leon Ave Ne, 920 Ponce De Leon Ave, Atlanta, GA 30306-4212 | 2006-08-24 |
| 1407365224 | Ascension Wellness Inc | Preferred Provider Organization | 1800 Peachtree St Nw Ste 660, Atlanta, GA 30309-2522 | 2017-09-25 |
| 1538559729 | Mind's Eye Enterprises, LLC | Preferred Provider Organization | 455 E Paces Ferry Rd Ne, Suite 332, Atlanta, GA 30305-3313 | 2015-01-27 |
| Find all providers in ATLANTA | ||||
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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.