CENTERS FOR PEDIATRIC DENTAL SEDATION LLC (NPI# 1396108056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396108056 |
| Entity Type | Organization |
| Organization Name | CENTERS FOR PEDIATRIC DENTAL SEDATION LLC |
| Practice Address |
1631 Phoenix Blvd Ste 8 College Park GA 30349-5545 |
| Mailing Address |
Po Box 370160 Decatur GA 30037-0160 |
| Practice Telephone | 6785451682 |
| Practice Fax Number | 6785190701 |
| Mailing Telephone | 4044034567 |
| Mailing Fax Number | 6785190701 |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2016-03-31 |
| Authorized Official Name | DR. MARCUS QURAN POLK (ANESTHESIOLOGIST) |
| Authorized Official Telephone | 4044034567 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
040758 | GA | Ambulatory Health Care Facilities |
| Street Address |
1631 PHOENIX BLVD STE 8 |
| City | COLLEGE PARK |
| State | GA |
| Zip Code | 30349-5545 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376185686 | Kmb Diagnostics | Durable Medical Equipment & Medical Supplies | 941 Flat Shoals Rd, Atlanta, GA 30349 | 2019-10-09 |
| 1114575859 | Justin Vassell | Registered Nurse | 1903 Phoenix Boulevard, Suite 200, College Park, GA 30349 | 2019-08-27 |
| 1841856663 | Kennyetta Danielle Watkins | Counselor | 1431 Riverwalk Ln, Apt. F, College Park, GA 30349 | 2019-05-16 |
| 1275002636 | Patriot Healthcare of Georgia, LLC | Family Medicine | 1587 Phoenix Boulevard, Suite 6, College Park, GA 30349 | 2018-11-15 |
| 1669971875 | Ee Consulting Solution | Case Management | 6320 Topaz Tral, Arlanta, GA 30349 | 2018-02-03 |
| 1629595640 | Shayla Bouie | Contractor | 5420 Riverdale Rd Apt D17, Atlanta, GA 30349 | 2017-08-30 |
| 1114475563 | Jasmine V Mccully | Social Worker | 5864 Summergien Lane, College Park, GA 30349 | 2016-09-14 |
| 1639537681 | Shelia Thornton | Counselor | 5856 Seabright Lane, Atlanta, GA 30349 | 2016-02-05 |
| 1346610177 | Joanne Resilard | Nurse Practitioner | 2931 Herron Ln Sw, Atlanta, GA 30349 | 2015-10-06 |
| 1063805091 | Southwest Atlanta Medical & Rehabilitation Clinic LLC | Family Medicine | 495 85 Circle, Suite 100, Atlanta, GA 30349 | 2015-03-16 |
| Find all providers in zip 30349 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548733710 | Paragon Dental, LLC | Clinic/Center | 9009 Rhode Island Ave, College Park, MD 20740-1929 | 2019-01-09 |
| 1275089633 | Gunita Singh, LLC | Clinic/Center | 7100 Baltimore Ave, Suite 200, College Park, MD 20740-3627 | 2016-08-26 |
| 1912188848 | Dharmesh Parbhoo P.C. | Clinic/Center | 1177 Garden Walk Blvd, College Park, GA 30349-6245 | 2007-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922606490 | Smile Pleasant Hill LLC | Clinic/Center | 828 Pleasant Hill Rd Nw Ste 10, Lilburn, GA 30047-2757 | 2020-10-15 |
| 1982213583 | Munoz Dental Resources LLC | Clinic/Center | 4141 Steve Reynolds Blvd Ste 1, Norcross, GA 30093-3060 | 2020-07-29 |
| 1407474794 | Familia Dentistry of Georgia, LLC | Clinic/Center | 4574 Lawrenceville Hwy Nw Ste 120r, Lilburn, GA 30047-3605 | 2020-07-13 |
| 1336763648 | Bethlehem Orthodontics | Clinic/Center | 426 Exchange Blvd Ste 400, Bethlehem, GA 30620-1791 | 2020-06-02 |
| 1770106882 | Smiles By Dixon PC | Clinic/Center | 690 Lanier Park Dr, Gainesville, GA 30501-2061 | 2020-05-22 |
| 1811516479 | Mouthpeace Dental 4, LLC | Clinic/Center | 541 Forest Pkwy Ste 18, Forest Park, GA 30297-6110 | 2020-04-14 |
| 1427677541 | Mh Dental Group, LLC | Clinic/Center | 1305 Cedarcrest Rd Ste 115, Dallas, GA 30132-8201 | 2020-04-09 |
| 1104451160 | Sno Healthcare Group | Clinic/Center | 2424 Roswell Rd Ste 120, Marietta, GA 30062 | 2020-03-10 |
| 1952935710 | West Cobb Periodontics and Implant Dentistry LLC | Clinic/Center | 44 Old Hamilton Rd Nw Ste 200, Marietta, GA 30064-5901 | 2020-03-02 |
| 1659904241 | Dental Now Kids LLC | Clinic/Center | 4151 Steve Reynolds Blvd Ste 2, Norcross, GA 30093-3060 | 2020-02-21 |
| Find all providers with the same taxonomy | ||||
| City | COLLEGE PARK |
| Zip Code | 30349 |
Please comment or provide details below to improve the information on CENTERS FOR PEDIATRIC DENTAL SEDATION LLC.
| 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.