YOUNG SMILES DENTISTRY FOR KIDS (NPI# 1174832802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174832802 |
| Entity Type | Organization |
| Organization Name | YOUNG SMILES DENTISTRY FOR KIDS |
| Practice Address |
4150 Macland Rd Suite 205 Powder Springs GA 30127-1202 |
| Practice Telephone | 7702221344 |
| Mailing Telephone | 7702221344 |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2010-09-29 |
| Authorized Official Name | DR. KEVIN R JACKSON (DENTIST) |
| Authorized Official Telephone | 7702221344 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Street Address |
4150 MACLAND RD SUITE 205 |
| City | POWDER SPRINGS |
| State | GA |
| Zip Code | 30127-1202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467477240 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 4150 Macland Rd, Powder Springs, GA 30127-1202 | 2006-07-13 |
| 1578174397 | Austin Billings | Pharmacist | 4150 Macland Rd, Powder Springs, GA 30127-1202 | 2020-08-14 |
| 1649403247 | Vanessa Dawn Irvine | Dental Assistant | 4150 Macland Rd, Powder Springs, GA 30127-1202 | 2009-08-29 |
| 1922267673 | Uche A Anikpe | Pharmacist | 4150 Macland Rd, Powder Springs, GA 30127-1202 | 2008-06-07 |
| 1265570683 | Kevin R Jackson | Dentist | 4150 Macland Rd, Suite 205, Powder Springs, GA 30127-1202 | 2007-02-01 |
| 1144368267 | Paula L. Coates | Dentist | 4150 Macland Rd, Suite 205, Powder Springs, GA 30127-1202 | 2007-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922580935 | Judette Barthelemy | Nurse Practitioner | 5280 Jones Reserve Walk, Powder Springs, GA 30127 | 2018-09-06 |
| 1174049837 | Patricia Anderson | Home Health Aide | 4089 Sweetsprings Terrace Southwest, Powder Springs, GA 30127 | 2017-08-15 |
| 1972028777 | Jonathan J Jones Jr. | Technician | 4089 Sweetsprings Terrace Sw, Powder Springs, GA 30127 | 2017-08-14 |
| 1124575279 | Thomas Jones | Private Vehicle | 3271 Barnwell Trce, Powder Springs, GA 30127 | 2016-09-07 |
| 1194184598 | Francesca Momplaisir | Chiropractor | 4851 Saddlerun Ln, Powder Springs, GA 30127 | 2016-02-15 |
| 1639535073 | Yonide Lareche | Nurse Practitioner | 184 Windriver Trik, Powderspring, GA 30127 | 2016-01-14 |
| 1740607035 | Health Star Home Health Care LLC | Home Health | 2148 Chaseford Ln, Powder Springs, GA 30127 | 2014-03-25 |
| 1073850855 | Charles Cordaro | Pharmacist | 2000 East West Connector, Health Services Center, 1st Floor - Pharmacy, Austell, GA 30127 | 2013-01-14 |
| 1669748539 | Scott Gynecology & Pelvic Surgery, P.C. | Obstetrics & Gynecology | 5041 Dallas Highway, Building 1, Suite G, Powder Springs, GA 30127 | 2012-03-26 |
| 1265706576 | Danielle Olivier Mental Health Services | Community/Behavioral Health | 3468 Hollow Stream Trail, Powder Prings, GA 30127 | 2012-03-05 |
| Find all providers in zip 30127 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| 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. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265570683 | Kevin R Jackson | Dentist | 4150 Macland Rd, Suite 205, Powder Springs, GA 30127-1202 | 2007-02-01 |
| 1144368267 | Paula L. Coates | Dentist | 4150 Macland Rd, Suite 205, Powder Springs, GA 30127-1202 | 2007-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740895002 | Ashley Starnesdmd LLC | Dentist | 5482 Chamblee Dunwoody Rd Ste 9, Dunwoody, GA 30338-4142 | 2020-09-14 |
| 1912518531 | Samuel S Kwon - Athens Dmd PC | Dentist | 1795 Resurgence Drive, Suite 101, Watkinsville, GA 30677 | 2020-08-17 |
| 1366060618 | A Dental Home 4 Kidz | Dentist | 155 Carnegie Pl Ste 201, Fayetteville, GA 30214-3981 | 2020-07-13 |
| 1255973566 | Rehoboth Life Care Ministries, Inc | Dentist | 3208 Hwy 41, Byron, Byron, GA 31008 | 2019-10-09 |
| 1629619200 | Peachtree Hills Pediatric Dentistry | Dentist | 2385 Peachtree Rd Ne Ste A2ab, Atlanta, GA 30305-4139 | 2019-10-04 |
| 1871145557 | Dogwood Pediatric Dentistry of Statesboro, LLC | Dentist | 123 Hill Pond Ln, Statesboro, GA 30458-0872 | 2019-07-12 |
| 1952969396 | Ns3 Services, LLC | Dentist | 1039 Grant St Se Ste B11, Atlanta, GA 30315-2050 | 2019-05-31 |
| 1871050872 | Warner Robins Pediatric Dentistry LLC | Dentist | 102 S Houston Rd, Warner Robins, GA 31088-3904 | 2019-02-26 |
| 1730646886 | Smiles for Kids Norcross PC | Dentist | 3953 Holcomb Bridge Rd Ste 100, Peachtree Corners, GA 30092-5201 | 2019-02-25 |
| 1073083127 | Pediatric Dentistry of Central Georgia - Macon LLC | Dentist | 5437 Bowman Rd Ste 300, Macon, GA 31210-6575 | 2018-12-03 |
| Find all providers with the same taxonomy | ||||
| City | POWDER SPRINGS |
| Zip Code | 30127 |
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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.