PERRY STREET DENTAL, P.C. (NPI# 1407208291) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407208291 |
| Entity Type | Organization |
| Organization Name | PERRY STREET DENTAL, P.C. |
| Practice Address |
53 Perry St Newnan GA 30263-1935 |
| Mailing Address |
1090 Northchase Pkwy Se Ste 150 Marietta GA 30067-6407 |
| Practice Telephone | 7702513465 |
| Mailing Telephone | 7709165031 |
| Mailing Fax Number | 6782477966 |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2016-07-06 |
| Authorized Official Name | THOMAS F. MOYNAHAN (PRESIDENT) |
| Authorized Official Telephone | 7702513465 |
| Authorized Official Credential | D.M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers | ||
| N | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers | ||
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers | ||
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers | ||
| Y | 122300000X | Dentist | Dental Providers |
| Street Address |
53 PERRY ST |
| City | NEWNAN |
| State | GA |
| Zip Code | 30263-1935 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215144431 | Nancy M Carson | Dentist | 53 Perry St, Newnan, GA 30263-1935 | 2007-05-17 |
| 1144439167 | Thomas F Moynahan | Dentist | 53 Perry St, Newnan, GA 30263-1935 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750914115 | Tina Harvey | Counselor | 55 A, Suite A, Newnan, GA 30263 | 2020-02-13 |
| 1407492846 | Pathways Center for Behavioral & Developmental Growth | Community/Behavioral Health | 78 Hospital Road, Newnan, GA 30263 | 2019-11-20 |
| 1831672047 | Jp & Jg Enterprises | Hospice Care, Community Based | 22 Madras Parkway, Newnan, GA 30263 | 2018-09-13 |
| 1376052928 | Newnan Endoscopy Center LLC | Clinic/Center | 1200 Lower Fayetteville Rd, Newnan, GA 30263 | 2017-09-27 |
| 1417314899 | Natalie Stephens | Speech-Language Pathologist | 87 Matador Way, Newnan, GA 30263 | 2016-01-15 |
| 1376943423 | Kathryn R Fletcher | Case Manager/Care Coordinator | 30 O'tara Woods Drive, Newnan, GA 30263 | 2014-08-26 |
| 1912260068 | Tamecia Hill | Counselor | 37 2nd Ave., Newnan, GA 30263 | 2012-06-22 |
| 1013289255 | Pathways Center for Behavioral and Developmental Growth | Community/Behavioral Health | 52 Perry St, Newnan, GA 30263 | 2012-02-03 |
| 1245513092 | Rocky Mountain Holdings LLC | Ambulance | 180 W Aviation Way, Newnan, GA 30263 | 2011-09-27 |
| 1316240427 | Georgia Cvs Pharmacy, LLC | Durable Medical Equipment & Medical Supplies | 395 Jackson St, Newnan, GA 30263 | 2010-12-10 |
| Find all providers in zip 30263 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700404522 | Rocio Jacobo Rubio | Dentist | 23 Old Atlanta Hwy Ste 200, Newnan, GA 30263-6341 | 2020-07-08 |
| 1427587229 | Vinh T Duong | Dentist | 2680 Highway 34 E, Newnan, GA 30265-1330 | 2017-06-06 |
| 1841464195 | Michael L Rayburn | Dentist | 22 Jackson St, Newnan, GA 30263-1910 | 2008-04-17 |
| 1366628984 | Oak Hill Dentistry PC | Dentist | 20 Baker Rd Ste 6, Newnan, GA 30265-2134 | 2008-01-14 |
| 1295822476 | Noel Francis Parris | Dentist | 20 Baker Rd, Suite 6, Newnan, GA 30265-2134 | 2006-10-06 |
| 1801998919 | Charley A Cheney IIi | Dentist | 2819 Highway 34 E, Newnan, GA 30265-1331 | 2006-09-01 |
| 1831619642 | Complete Dental Arts, P.C. | Dentist | 2819 Highway 34 E, Newnan, GA 30265-1331 | 2017-06-22 |
| 1891141792 | Hugh Smaltz | Dentist | 1605 Highway 34 E Ste A1, Newnan, GA 30265-2191 | 2016-05-10 |
| 1346694866 | Elkdental LLC | Dentist | 201 Newnan Crossing Byp, Newnan, GA 30265-1063 | 2016-04-21 |
| 1962878041 | Jason Lee Beck | Dentist | 7 Baynard Park, Newnan, GA 30265-6413 | 2015-08-12 |
| Find all providers in NEWNAN | ||||
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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.