FABULOUS SMILES OF LILBURN (NPI# 1205211133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205211133 |
| Entity Type | Organization |
| Organization Name | FABULOUS SMILES OF LILBURN |
| Practice Address |
331 Arcado Rd Nw Lilburn GA 30047-3077 |
| Practice Telephone | 7705570788 |
| Practice Fax Number | 4044202951 |
| Mailing Telephone | 7705570788 |
| Mailing Fax Number | 4044202951 |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2015-07-21 |
| Authorized Official Name | NIKKI ROLLS (OFFICE MANAGER) |
| Authorized Official Telephone | 7705570788 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305S00000X | Point of Service | DN011973 | GA | Managed Care Organizations |
| Street Address |
331 ARCADO RD NW |
| City | LILBURN |
| State | GA |
| Zip Code | 30047-3077 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023271186 | Thaddeus Harvey Jr. | Dentist | 331 Arcado Rd Nw, Lilburn, GA 30047-2814 | 2008-07-08 |
| 1417497678 | Krishiva Smiles, LLC | Dentist | 331 Arcado Rd Nw, Suite D, Lilburn, GA 30047-3077 | 2017-03-06 |
| 1265824965 | Kindtouch Healthcare Services LLC | Home Health | 331 Arcado Rd Nw, Suite A-104, Lilburn, GA 30047-3077 | 2015-03-04 |
| 1538456942 | Center for Counseling, Rehabilitation, & Personal Evaluation | Counselor | 331 Arcado Rd Nw, Suite B, Lilburn, GA 30047-2814 | 2011-07-06 |
| 1336378215 | Shilpa Dhawan | Dentist | 331 Arcado Rd Nw, Lilburn, GA 30047-2814 | 2009-07-13 |
| 1518109461 | Center for Counseling, Rehabilitation, and Personal Evaluation | Counselor | 331 Arcado Rd Nw, Suite B, Lilburn, GA 30047-2814 | 2009-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750861217 | Latrina S Walden | Nurse Practitioner | 887 Ryan Lane, Lilburn, GA 30047 | 2018-08-15 |
| 1811483928 | Olivia Oyegunle | Optometrist | 4153 Lawrenceville Hwy Nw Ste 5, Lilburn, GA 30047 | 2018-07-02 |
| 1932619285 | Mpm Creative, LLC | Speech-Language Pathologist | 1560 Hewatt Rd, Lilburn, GA 30047 | 2017-10-01 |
| 1528515186 | Smith Dental Care of Lilburn, Inc. | Dentist | 3100 Five Forks Trickham Rd Suite 201, Lilburn, GA 30047 | 2016-09-01 |
| 1891143244 | Choices Behavioral Alternatives | Counselor | 4037 Darling Court, Suite B, Lilburn, GA 30047 | 2016-05-26 |
| 1235595687 | Georgia Dental Associates | Clinic/Center | 3100 Five Forks Trickum Road Suite 201, Lilburn, GA 30047 | 2016-01-14 |
| 1912382144 | Sangeetha Asokan | Dentist | 609, Beaver Ruin Road, Tebo Dental for Kids, Lilburn, GA 30047 | 2015-07-29 |
| 1467836403 | Pamela Neal | Registered Nurse | 3315 Landingview Ct, Lilburn, GA 30047 | 2015-07-18 |
| 1699172452 | Josie Kou, Kulah Curran | Registered Nurse | 3708 Tamer Ln, Lilburn, GA 30047 | 2014-11-21 |
| 1184039380 | Cheryl Lee | Chiropractor | 5014 Stone Mountain Hwy, Suite C, Lilburn, GA 30047 | 2014-06-25 |
| Find all providers in zip 30047 | ||||
| Taxonomy Code | 305S00000X |
| Grouping | Managed Care Organizations |
| Classification | Point of Service |
| This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851729883 | Avala Dental Providers,llc | Point of Service | 629 A Beaver Ruin Rd, Lilburn, GA 30047 | 2013-10-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811597461 | Nanoresearch, Inc | Point of Service | 58 Edgewood Ave Ne, Suite 122, Collabtech., Gsu, Atlanta, GA 30303 | 2020-10-31 |
| 1558990911 | Telemedicine Essentials of America, LLC | Point of Service | 2001 Montreal Rd Ste 105, Tucker, GA 30084-5219 | 2020-04-06 |
| 1033745088 | Assure Elder Care Incorporated | Point of Service | 1047 Alford Rd, Lithonia, GA 30058-3007 | 2020-03-20 |
| 1437712122 | Wish You Well Youth Faith Foundation Inc | Point of Service | 9456 S Main St Ste D4, Jonesboro, GA 30236-6074 | 2019-04-17 |
| 1114412632 | Healthy Living Now Inc | Point of Service | 8174 Spring Ct, Riverdale, GA 30274-4317 | 2018-06-27 |
| 1629519202 | Nurse Practioner | Point of Service | 4044 George Busbee Pkwy Nw Apt 4207, Kennesaw, GA 30144-6890 | 2017-03-15 |
| 1033657143 | Glam She LLC | Point of Service | 4070 San Marco Way, Douglasville, GA 30135-2769 | 2017-02-09 |
| 1992248298 | New Legacy Counseling and Training Center | Point of Service | 3350 Riverwood Parkway, Suite 1925, Atlanta, GA 30339 | 2016-11-18 |
| 1245682079 | Butterfly Gardens Hopice & Palliative Care, LLC | Point of Service | 3112 Blackmon Ct, Hephzibah, GA 30815-7064 | 2016-07-05 |
| 1194179861 | A Humbling Spirit Family Practice, Inc. | Point of Service | 2412 Horseshoe Bend Rd Sw, Marietta, GA 30064-4412 | 2016-04-19 |
| Find all providers with the same taxonomy | ||||
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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.