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KELLIE SMITH CASTRO DENTISTRY LLC NPI 1730691874


NPI Information

NPI: 1730691874
Provider Name: KELLIE SMITH CASTRO DENTISTRY LLC

Doing Business As: DENTISTRY AT THE MILLS

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
1860 DULUTH HWY STE 401
LAWRENCEVILLE, GA
ZIP 30043
Phone: (678) 226-9063
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KELLIE SMITH CASTRO DENTISTRY LLC is a general practice dentist in Lawrenceville, GA. The provider is 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. KELLIE SMITH CASTRO DENTISTRY LLC NPI is 1730691874. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Dentistry At The Mills.

The provider's business location address is:

1860 DULUTH HWY STE 401
LAWRENCEVILLE, GA
ZIP 30043-061
Phone: (678) 226-9063
Fax: (678) 226-9445

The provider's authorized official is Kellie Castro .
The authorized official title is Owner/dentist and has the following contact phone number (678) 226-9063.

The enumeration date for this NPI number is 10/30/2017 and was last updated on 10/30/2017.


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
11223G0001XDentistGeneral PracticeDN015357GEORGIAYes

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
11619289246OTHERNORTH CAROLINAN/A

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: 11/14/2023

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