Healther Providers Data Logo


Provider Type Icon

TEBO DENTISTRY FOR KIDS DACULA LLC NPI 1689938862


NPI Information

NPI: 1689938862
Provider Name: TEBO DENTISTRY FOR KIDS DACULA, LLC
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
1152 AUBURN RD
BUILDING 1, SUITE 101
DACULA, GA
ZIP 30019
Phone: (770) 925-3300
Get Directions

TEBO DENTISTRY FOR KIDS DACULA, LLC is a pediatric dentistry dentist in Dacula, 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. TEBO DENTISTRY FOR KIDS DACULA, LLC NPI is 1689938862. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1152 AUBURN RD
BUILDING 1, SUITE 101
DACULA, GA
ZIP 30019-444
Phone: (770) 925-3300

The provider's authorized official is Jenniffer Connor .
The authorized official title is Administrative Assistant and has the following contact phone number (678) 990-6331.

The enumeration date for this NPI number is 7/2/2012 and was last updated on 7/2/2012.


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 PracticeDN009113No
21223G0001XDentistGeneral PracticeDN013919GEORGIANo
31223G0001XDentistGeneral PracticeDN013997GEORGIANo
41223G0001XDentistGeneral PracticeDN011863GEORGIANo
51223P0221XDentistPediatric DentistryDN009113GEORGIAYes

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
11730316597OTHERGEORGIANPI
21033449517OTHERGEORGIANPI
3124533238OTHERNPI
41245432004OTHERGEORGIANPI

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
Remove or sync iconNPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI
Next NPI »