BUCKHEAD COSMETIC AND FAMILY DENTISTRY LLC


Address: 316 Pharr Rd Ne, Atlanta, GA 30305-2304
Phone: 4044000400

BUCKHEAD COSMETIC AND FAMILY DENTISTRY LLC (NPI# 1407361702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1407361702
Entity Type Organization
Organization Name BUCKHEAD COSMETIC AND FAMILY DENTISTRY LLC
Practice Address 316 Pharr Rd Ne
Atlanta
GA 30305-2304
Practice Telephone 4044000400
Practice Fax Number 4043936929
Mailing Telephone 4044000400
Mailing Fax Number 4043936929
Enumeration Date 2017-12-08
Last Update Date 2017-12-08
Authorized Official Name BAHAREH EMADZADEH NIA (OWNER)
Authorized Official Telephone 4044000400
Authorized Official Credential DMD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261Q00000X Clinic/Center DN013675 GA Ambulatory Health Care Facilities

Office Location

Street Address 316 PHARR RD NE
City ATLANTA
State GA
Zip Code 30305-2304

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1386195154 Ryan Gabriel Wilkins Physical Therapist 550 Pharr Rd Ne Ste 550, Atlanta, GA 30305 2016-10-17
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1588039275 Alaina Blevins Physician Assistant 240 Pharr Rd Ne, Atlanta, GA 30305 2015-12-07
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Taxonomy Information

Taxonomy Code 261Q00000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center

Taxonomy Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

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Competitor

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City ATLANTA
Zip Code 30305

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Dataset Information

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.

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