SMALLTOWN DENTAL ATLANTA (NPI# 1417515453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417515453 |
| Entity Type | Organization |
| Organization Name | SMALLTOWN DENTAL ATLANTA |
| Practice Address |
205 S Race St Atlanta IL 61723-7586 |
| Mailing Address |
Po Box 445 Atlanta IL 61723-0445 |
| Practice Telephone | 2176482828 |
| Mailing Telephone | 2176482828 |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2020-06-29 |
| Authorized Official Name | LUKE OVERCASH (OPERATIONS MANAGER) |
| Authorized Official Telephone | 3093705853 |
| Is Organization Subpart | Y |
| Parent Organization Name | SMALLTOWN DENTAL MANAGEMENT LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
205 S RACE ST |
| City | ATLANTA |
| State | IL |
| Zip Code | 61723-7586 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306404389 | Gabrielle Coe | Dentist | 205 S Race St, Atlanta, IL 61723-7586 | 2019-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548256860 | Sherman's Pharmacy | Pharmacy | 122 Sw 1st St., Atlanta, IL 61723-0566 | 2005-09-22 |
| 1164945721 | Danielle Christine Mont | Physical Therapy Assistant | 508 Sw 3rd St, Atlanta, IL 61723-7509 | 2017-07-25 |
| 1609129865 | Small Miracles Chiropractic Clinic Sc | Chiropractor | 110 Se Vine St Unit 2, Atlanta, IL 61723-7611 | 2012-10-24 |
| 1205973856 | Michelle Marie Maris | Specialist | 2332 2275th Ave, Atlanta, IL 61723-9000 | 2007-01-31 |
| 1396902664 | Nancy Anne Wrage | Developmental Therapist | 2324 1250th Ave, Atlanta, IL 61723-9336 | 2008-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841038 | Kathryn Louis | Doula | 301 Atlanta Ave Se Apt 5, Atlanta, GA 30315-2037 | 2020-11-08 |
| 1477154110 | Christina Danielle Palau Vaccari | Nurse Practitioner | 712 Pasley Ave Se, Atlanta, GA 30316-2158 | 2020-11-07 |
| 1902407752 | Neighbormd of Atlanta LLC | Internal Medicine | 285 Boulevard Ne Ste 435&436, Atlanta, GA 30312-4205 | 2020-11-06 |
| 1053912907 | Neighbormd of North Atlanta LLC | Internal Medicine | 1800 Peachtree St Nw Ste 730nw, Atlanta, GA 30309-2519 | 2020-11-06 |
| 1285235036 | Neighbormd of South Atlanta LLC | Internal Medicine | 3885 Princeton Lakes Way Sw Ste 412, Atlanta, GA 30331-5599 | 2020-11-06 |
| 1073114286 | Sadiecare Health Services Incorporated | Home Health | 483 Holderness St Sw Unit B, Atlanta, GA 30310-1748 | 2020-11-04 |
| 1588265839 | Mina Xia | Dietitian, Registered | 7007 Kingswood Run Dr, Atlanta, GA 30340-1865 | 2020-11-03 |
| 1790386258 | Thrive Orthopaedics LLC | Orthopaedic Surgery | 5775 Peachtree Dunwoody Rd Ne Ste C150a, Atlanta, GA 30342-1501 | 2020-11-02 |
| 1811597461 | Nanoresearch, Inc | Point of Service | 58 Edgewood Ave Ne, Suite 122, Collabtech., Gsu, Atlanta, GA 30303 | 2020-10-31 |
| 1356941082 | Just Peachy Home Care LLC | Home Health | 550 Fairburn Rd Sw Ste B1, Atlanta, GA 30331-2016 | 2020-10-30 |
| Find all providers in ATLANTA | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891336830 | Atlanta Dental Fitness | Clinic/Center | 2296 Henderson Mill Rd Ne Ste 109, Atlanta, GA 30345-2739 | 2019-10-01 |
| 1245881515 | Wayne G Suway D.d.s., PC | Clinic/Center | 1820 The Exchange Se Ste 600, Atlanta, GA 30339-2083 | 2019-09-26 |
| 1033699921 | Meridian Education Resource Group, Inc. | Clinic/Center | 65 Rogers St Ne, Atlanta, GA 30317-1018 | 2018-08-20 |
| 1174979082 | Greenbriar Dental Care, P.C. | Clinic/Center | 2841 Greenbriar Pkwy Sw Ste X306, Atlanta, GA 30331-2635 | 2016-05-10 |
| 1164815254 | Pain Away Dentistry, LLC | Clinic/Center | 5626 Fulton Industrial Blvd Sw, Ste 110, Atlanta, GA 30336-2641 | 2015-03-12 |
| 1578809919 | Georgia Dental Care Inc | Clinic/Center | 5025 Winters Chapel Rd, Suite F, Atlanta, GA 30360-1700 | 2012-12-12 |
| 1770834954 | Edgewood Dental Center | Clinic/Center | 545 Edgewood Ave Se, Atlanta, GA 30312-1936 | 2012-09-27 |
| 1871853366 | International Harvest Dentistry | Clinic/Center | 5555 Peachtree Dunwoody Rd Ne Ste G73, Atlanta, GA 30342-1787 | 2012-05-18 |
| 1306104260 | Powell and Associates Dds, PC | Clinic/Center | 2800 Spring Road, Suite F-2, Atlanta, GA 30339-3092 | 2012-04-30 |
| 1679782585 | J. Stephen Buckler, Dmd, PC | Clinic/Center | 3632 Chamblee Tucker Rd, Atlanta, GA 30341-4418 | 2007-05-21 |
| Find all providers in ATLANTA | ||||
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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.