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DECATUR DENTAL GROUP LLC NPI 1891002531


NPI Information

NPI: 1891002531
Provider Name: DECATUR DENTAL GROUP, LLC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
3660 FLAT SHOALS RD
SUITE 100
DECATUR, GA
ZIP 30034
Phone: (404) 243-0217
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DECATUR DENTAL GROUP, LLC is a general practice dentist in Decatur, 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. DECATUR DENTAL GROUP, LLC NPI is 1891002531. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3660 FLAT SHOALS RD
SUITE 100
DECATUR, GA
ZIP 30034-632
Phone: (404) 243-0217
Fax: (404) 243-9313

The provider's authorized official is Resa Johnelle Roberts .
The authorized official title is Organizer and has the following contact phone number (404) 556-1393.

The enumeration date for this NPI number is 9/1/2010 and was last updated on 9/21/2011.


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 PracticeDN010168GEORGIAYes

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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