GEORGIA DENTAL PROFESSIONALS, PC (NPI# 1124576954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124576954 |
| Entity Type | Organization |
| Organization Name | GEORGIA DENTAL PROFESSIONALS, PC |
| Other Organization Name | SEASIDE LIFETIME DENTISTRY |
| Practice Address |
165 Juniper Cir Brunswick GA 31520-1953 |
| Practice Telephone | 9125544552 |
| Mailing Telephone | 9125544552 |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2016-09-21 |
| Authorized Official Name | CASSANDRA N TEUTSCH (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 2175408972 |
| Is Organization Subpart | Y |
| Parent Organization Name | GEORGIA DENTAL PROFESSIONALS, PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Seaside Lifetime Dentistry | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760098214 | Georgia Dental Professionals, PC | Dentist | 3000 Chapel Hill Rd Ste 104, Douglasville, GA 30135-1841 | 2020-09-21 |
| 1063028769 | Georgia Dental Professionals, PC | Dentist | 3364 Hamilton Mill Rd, Buford, GA 30519-4005 | 2020-09-17 |
| 1306452016 | Georgia Dental Professionals, PC | Dentist | 2680 Highway 34 E Ste A, Newnan, GA 30265-1330 | 2020-09-17 |
| 1720693690 | Georgia Dental Professionals, PC | Dentist | 3625 Browns Bridge Rd Ste 101, Cumming, GA 30028-4198 | 2020-09-09 |
| 1285242693 | Georgia Dental Professionals, PC | Dentist | 5185 Peachtree Pkwy Ste 201, Norcross, GA 30092-6539 | 2020-07-22 |
| 1780220194 | Georgia Dental Professionals, PC | Dentist | 4355 Towne Lake Pkwy, Woodstock, GA 30189-8150 | 2019-11-20 |
| 1831746999 | Georgia Dental Professionals, PC | Dentist | 1207 Highway 74 S, Peachtree City, GA 30269-3078 | 2019-08-23 |
| 1972165207 | Georgia Dental Professionals, PC | Dentist | 516 Ga Highway 247 S, Bonaire, GA 31005-3865 | 2019-07-08 |
| 1710546148 | Georgia Dental Professionals, PC | Dentist | 8022 Cumming Hwy, Canton, GA 30115-9337 | 2019-06-10 |
| 1730747528 | Georgia Dental Professionals, PC | Dentist | 920 Loganville Hwy Ste 100, Bethlehem, GA 30620 | 2019-06-05 |
| Street Address |
165 JUNIPER CIR |
| City | BRUNSWICK |
| State | GA |
| Zip Code | 31520-1953 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760953434 | David S Deuser Md & Associates PC | Psychiatry & Neurology | 7 Saint Andrews Court, Brunswick, GA 31520 | 2018-12-06 |
| 1063961845 | Irene Limon | Licensed Practical Nurse | 2009 Ellis Street, Brunswick, GA 31520 | 2016-09-22 |
| 1770936551 | Elaine Latimer-tandy | Counselor | 1801 Gloucester St Ste E, Brunswick, GA 31520 | 2016-07-18 |
| 1710336326 | Giva, Inc. | Home Health | 8 St Andrews Court, Brunswick, GA 31520 | 2016-06-06 |
| 1447618525 | Parmelee Eye Care LLC | Point of Service | 1909 Gloucester St, Brunswick, GA 31520 | 2016-02-04 |
| 1578947800 | Holly Diskin Kinsey | Nurse Practitioner | 3400 Parkwood Drive, Brunswick, GA 31520 | 2015-07-16 |
| 1679976419 | Miriam Hosey | Registered Nurse | 2747 Fourth Street, Glynn County Health Dept., Brunswick, GA 31520 | 2014-10-08 |
| 1558779348 | Tracey Renee Price | Internal Medicine | 3025 Shrine Rd Ste 290, Brunswick, GA 31520 | 2014-07-24 |
| 1770901951 | Candace Shepherd | Social Worker | 707 F Street, Brunswick, GA 31520 | 2014-04-03 |
| 1699193599 | Enrique Martinez, M.d., P.C. | Internal Medicine | 3114 A Shrine Road, Brunswick, GA 31520 | 2014-03-29 |
| Find all providers in zip 31520 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386204568 | Keni Leonce | Dentist | 11455 Canal Xing, Brunswick, GA 31525-6747 | 2019-06-19 |
| 1497260145 | Brunswick Dentisty LLC | Dentist | 4741 Altama Ave, Brunswick, GA 31520-2910 | 2017-12-04 |
| 1336430123 | Mary Anne Mackey | Dentist | 64 Pleasant St, Brunswick, ME 04011-2203 | 2011-04-27 |
| 1275703522 | Joe C. Massey | Dentist | 1108 1st St, Brunswick, GA 31520-4512 | 2008-03-03 |
| 1518162197 | Peter M Mazzeo | Dentist | 1026 Pearl Road, Suites 1 & 2, Brunswick, OH 44212 | 2007-06-15 |
| 1437364338 | George Michael Wommack | Dentist | 2900 Glynn Ave, Brunswick, GA 31520-4844 | 2007-05-14 |
| 1538374822 | Darryl Dale Daniel I | Dentist | 11 Professional Dr, Brunswick, GA 31520-3773 | 2007-05-11 |
| 1750501227 | Brian P. Kudla | Dentist | 2111 Pearl Rd, Brunswick, OH 44212-3245 | 2007-04-26 |
| 1649393851 | Robert William Mandel | Dentist | 3864 Center Rd, Brunswick, OH 44212 | 2007-04-10 |
| 1184746307 | Kevin Clark Smith | Dentist | 610 Ninth Ave, Brunswick, MD 21716-1828 | 2007-04-06 |
| Find all providers in BRUNSWICK | ||||
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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.