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SOUTHERN SMILES FAMILY DENTISTRY INC. NPI 1720395924


NPI Information

NPI: 1720395924
Provider Name: SOUTHERN SMILES FAMILY DENTISTRY, INC.
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
475 BILL KENNEDY WAY SE
SUITE D & E
ATLANTA, GA
ZIP 30316
Phone: (404) 622-0622
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SOUTHERN SMILES FAMILY DENTISTRY, INC. is a general practice dentist in Atlanta, 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. SOUTHERN SMILES FAMILY DENTISTRY, INC. NPI is 1720395924. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

475 BILL KENNEDY WAY SE
SUITE D & E
ATLANTA, GA
ZIP 30316-847
Phone: (404) 622-0622
Fax: (404) 622-0624

The provider's authorized official is Genise A Evans .
The authorized official title is Dentist and has the following contact phone number (404) 622-0622.

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


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 PracticeDN012623GEORGIAYes

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
11548362718OTHERGEORGIAINDIVIDUAL NPI #
2000957712KMEDICAIDGEORGIA

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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