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VILLA RICA FAMILY DENTAL NPI 1780832386


NPI Information

NPI: 1780832386
Provider Name: VILLA RICA FAMILY DENTAL
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
865 S CARROLL RD STE C
VILLA RICA, GA
ZIP 30180
Phone: (770) 459-4131
Get Directions

VILLA RICA FAMILY DENTAL is a general practice dentist in Villa Rica, 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. VILLA RICA FAMILY DENTAL NPI is 1780832386. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

865 S CARROLL RD STE C
VILLA RICA, GA
ZIP 30180-056
Phone: (770) 459-4131
Fax: (770) 459-4132

The provider's authorized official is Jamey Chang .
The authorized official title is Dentist and has the following contact phone number (770) 459-4131.

The enumeration date for this NPI number is 9/8/2008 and was last updated on 9/8/2008.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeDN0112559GEORGIAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1129648207AMEDICAIDGEORGIA

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: 5/5/2024

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