CEDAR DENTAL CLINICAL I, LLC (NPI# 1073120002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073120002 |
| Entity Type | Organization |
| Organization Name | CEDAR DENTAL CLINICAL I, LLC |
| Practice Address |
494 Booth Rd Ste 1a Warner Robins GA 31088-3435 |
| Mailing Address |
6801 Governors Lake Pkwy Ste 290 Peachtree Corners GA 30071-1136 |
| Practice Telephone | 4783220060 |
| Practice Fax Number | 4783220065 |
| Mailing Telephone | 6789783099 |
| Mailing Fax Number | 6786914425 |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2020-09-24 |
| Authorized Official Name | MR. HENRY RANKIN DALLAM III (PRESIDENT) |
| Authorized Official Telephone | 7703312529 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | GA DENTAL LICENSE | DN013071 | 01 |
| Other Name | Type Code |
|---|---|
| Orthodontic Care of Georgia | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003423039 | Cedar Dental Clinical I, LLC | Dentist | 119 Willow Ln, Mcdonough, GA 30253-6574 | 2020-09-24 |
| 1942817960 | Cedar Dental Clinical I, LLC | Dentist | 4272 Washington Rd Ste 7a, Evans, GA 30809-3073 | 2020-09-24 |
| 1366059396 | Cedar Dental Clinical I, LLC | Dentist | 18 Riverbend Dr Sw Ste 230, Rome, GA 30161-6019 | 2020-09-24 |
| 1740897776 | Cedar Dental Clinical I, LLC | Dentist | 3630 Thompson Bridge Rd Ste 18b, Gainesville, GA 30506-1524 | 2020-09-24 |
| 1790392710 | Cedar Dental Clinical I, LLC | Dentist | 6801 Governors Lake Pkwy Ste 290, Peachtree Corners, GA 30071-1136 | 2020-09-24 |
| Street Address |
494 BOOTH RD STE 1A |
| City | WARNER ROBINS |
| State | GA |
| Zip Code | 31088-3435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982218921 | Sarah Newman | Pharmacist | 1081 Ga-96, Warner Robins, GA 31088 | 2020-09-08 |
| 1619599115 | Alana Jane Sibley | Registered Nurse | 940 Ga - 96, Warner Robins, GA 31088 | 2020-05-07 |
| 1033779657 | Jodi Lynne Pettygrove | Nurse Practitioner | 115 Havelock Cir, Warner Robins, GA 31088 | 2019-06-17 |
| 1164994901 | Gwendolyn Jordan Taylor | Registered Nurse | 940-c Ga Hwy 96, Same, Warner Robins, GA 31088 | 2018-12-18 |
| 1447721543 | Amy Tanner | Behavioral Analyst | 200 Cresview Church Rd #1806, Warner Robins, GA 31088 | 2018-12-16 |
| 1518435676 | Phoenix Health Center | Case Management | 940 Ga-96, Warner Robins, GA 31088 | 2018-11-07 |
| 1427534320 | Jared Dean Johnson | Social Worker | 146 Lakepointe Drive, Warner Robins, GA 31088 | 2018-07-13 |
| 1285124180 | Cmp Academy & Billing Service | Contractor | 105 S Commercial Circle, Warner Robins, GA 31088 | 2018-05-16 |
| 1730692377 | Benzer Pharmacy | Pharmacy | 150 S Houston Lake Rd Ste 300, Warner Robins, GA 31088 | 2017-11-06 |
| 1821507476 | Timothy Doyle Thomas | Registered Nurse | 940-c Hwy 96, Warner Robins, GA 31088 | 2017-09-27 |
| Find all providers in zip 31088 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528289154 | J. Don Spillers, Jr., Dmd, Ms, PC | Dentist | 400 Spillers Way, Warner Robins, GA 31088-0512 | 2007-05-01 |
| 1730253717 | Gary L Pool | Dentist | 1721 Russell Pkwy, Warner Robins, GA 31088-5707 | 2006-11-20 |
| 1700124062 | Adam Gordon | Dentist | 400 Spillers Way, Warner Robins, GA 31088-0512 | 2013-01-22 |
| 1568683258 | Jerry Don Spillers Jr. | Dentist | 400 Spillers Way, Warner Robins, GA 31088-0512 | 2007-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144828765 | Sharma Orthodontics LLC | Dentist | 3535 Roswell Rd Ste 53, Marietta, GA 30062-8828 | 2020-10-15 |
| 1700484094 | Beltway Orthodontics | Dentist | 857 Collier Rd Nw Ste 5a-5b, Atlanta, GA 30318-2532 | 2020-10-09 |
| 1003423039 | Cedar Dental Clinical I, LLC | Dentist | 119 Willow Ln, Mcdonough, GA 30253-6574 | 2020-09-24 |
| 1942817960 | Cedar Dental Clinical I, LLC | Dentist | 4272 Washington Rd Ste 7a, Evans, GA 30809-3073 | 2020-09-24 |
| 1366059396 | Cedar Dental Clinical I, LLC | Dentist | 18 Riverbend Dr Sw Ste 230, Rome, GA 30161-6019 | 2020-09-24 |
| 1740897776 | Cedar Dental Clinical I, LLC | Dentist | 3630 Thompson Bridge Rd Ste 18b, Gainesville, GA 30506-1524 | 2020-09-24 |
| 1790392710 | Cedar Dental Clinical I, LLC | Dentist | 6801 Governors Lake Pkwy Ste 290, Peachtree Corners, GA 30071-1136 | 2020-09-24 |
| 1598379679 | Dr. Milan Dhanani PC | Dentist | 1905 Beaver Ruin Rd Ste 175b, Norcross, GA 30071-3837 | 2020-09-04 |
| 1316584758 | Classic City Orthodontics, LLC | Dentist | 1020 Jamestown Blvd Bldg 100, Watkinsville, GA 30677-4131 | 2019-12-04 |
| 1952957714 | Melisa Stewart | Dentist | 5555 Peachtree Dunwoody Rd Ste 301, Atlanta, GA 30342-1712 | 2019-08-16 |
| Find all providers with the same taxonomy | ||||
| City | WARNER ROBINS |
| Zip Code | 31088 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.