FAYETTE DENTAL GROUP PC (NPI# 1356810634) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356810634 |
| Entity Type | Organization |
| Organization Name | FAYETTE DENTAL GROUP PC |
| Practice Address |
720 W Lanier Ave Fayetteville GA 30214 |
| Practice Telephone | 7706832284 |
| Enumeration Date | 2018-11-16 |
| Last Update Date | 2018-11-16 |
| Authorized Official Name | TASH-MARIE CHENEY (COO) |
| Authorized Official Telephone | 7706832284 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
720 W LANIER AVE |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| 1104303809 | St. Christophers Private Homecare Agency | Home Health | 110 Habersham Dr Ste 117, Fayetteville, GA 30214 | 2018-07-25 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437615408 | Dr Cameron and Associates Iv | Clinic/Center | 2301 Robeson St Ste 302, Fayetteville, NC 28305-5641 | 2019-02-14 |
| 1306329867 | James E Rice, Dds Pa | Clinic/Center | 3622 Morganton Rd, Fayetteville, NC 28303-4967 | 2018-09-11 |
| 1346744232 | Wedington Dental, Pllc | Clinic/Center | 3500 Black Forest Drvie, Ste 1, Fayetteville, AR 72704 | 2018-03-23 |
| 1639568777 | Hollis L Jones Dds, Pllc | Clinic/Center | 1782 Metromedical Dr, Fayetteville, NC 28304-3861 | 2015-01-13 |
| 1366856262 | Dr Cameron and Associates IIi, Pllc | Clinic/Center | 300 Glensford Drive, Fayetteville, NC 28314 | 2014-06-18 |
| 1053618801 | B.g.harrison D.d.s. and Associates, P.a. | Clinic/Center | 1408 Skibo Rd., Fayetteville, NC 28303 | 2011-02-14 |
| 1104155506 | Patrice A. Barber, Dds & Associates, Pa | Clinic/Center | 5428 Yadkin Rd, Fayetteville, NC 28303-3199 | 2009-12-14 |
| 1508471046 | Fayetteville Smiles Dentistry | Clinic/Center | 6962 Highbridge Rd, Fayetteville, NY 13066-9705 | 2020-09-11 |
| 1295373322 | Sequoyah Dental, Pllc | Clinic/Center | 2827 E Millennium Pl Ste 3, Fayetteville, AR 72703-6528 | 2019-12-19 |
| 1205496965 | Cmp Dental Arts Pllc | Clinic/Center | 7197 Highbridge Rd, Fayetteville, NY 13066-9784 | 2019-06-15 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
Please comment or provide details below to improve the information on FAYETTE DENTAL GROUP PC.
| 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.