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EAST COBB DENTISTRY FOR KIDS NPI 1346652062


NPI Information

NPI: 1346652062
Provider Name: EAST COBB DENTISTRY FOR KIDS
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
2880 JOHNSON FERRY RD
MARIETTA, GA
ZIP 30062
Phone: (678) 813-2388
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EAST COBB DENTISTRY FOR KIDS is a pediatric dentistry dentist in Marietta, GA. The provider is 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. EAST COBB DENTISTRY FOR KIDS NPI is 1346652062. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2880 JOHNSON FERRY RD
MARIETTA, GA
ZIP 30062-368
Phone: (678) 813-2388

The provider's authorized official is Nelson K Allen .
The authorized official title is Pediatric Dentistry and has the following contact phone number (678) 813-2388.

The enumeration date for this NPI number is 5/29/2014 and was last updated on 5/29/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223P0221XDentistPediatric DentistryDNO13148GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1896892351ABMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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