CHILDREN'S DENTAL CENTER, PC (NPI# 1427428085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427428085 |
| Entity Type | Organization |
| Organization Name | CHILDREN'S DENTAL CENTER, PC |
| Other Organization Name | CHILDREN'S DENTAL CENTER, PC OF ROME |
| Practice Address |
15 Riverbend Dr Sw Ste 130 Rome GA 30161-6005 |
| Practice Telephone | 7062321283 |
| Mailing Telephone | 7062321283 |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2015-09-25 |
| Authorized Official Name | JAMES W SHEALY JR. (PRESIDENT) |
| Authorized Official Telephone | 7062321283 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers | ||
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers | ||
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Children's Dental Center, PC of Rome | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871963447 | Children's Dental Center, PC | Dentist | 1010 N Tennessee St, Ste 105, Cartersville, GA 30120-8525 | 2015-09-25 |
| 1215005376 | Children's Dental Center, PC | Dentist | 16 Felton Pl # B, Cartersville, GA 30120-2152 | 2006-11-30 |
| Street Address |
15 RIVERBEND DR SW STE 130 |
| City | ROME |
| State | GA |
| Zip Code | 30161-6005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235110263 | Lori Ponder | Nurse Practitioner | 15 Riverbend Dr Sw, Ste 100, Rome, GA 30161-6065 | 2005-11-08 |
| 1548685811 | Ashley Ann Holloway | Nurse Practitioner | 15 Riverbend Dr Sw, Ste 100, Rome, GA 30161-6005 | 2014-02-24 |
| 1134468101 | Emma Cordle | Nurse Practitioner | 15 Riverbend Dr Sw, Ste 100, Rome, GA 30161-6005 | 2013-02-11 |
| 1083893150 | Kristen Higgins Leezer | Obstetrics & Gynecology | 15 Riverbend Dr Sw, Ste 200, Rome, GA 30161-6005 | 2007-10-25 |
| 1053462325 | Northwest Georgia Medical Clinic, P.C. | Specialist | 15 Riverbend Dr Sw, Ste 200, Rome, GA 30161-6065 | 2007-01-15 |
| 1861424004 | Lisa Blake | Obstetrics & Gynecology | 15 Riverbend Dr Sw, Ste 200, Rome, GA 30161-6065 | 2006-07-07 |
| 1336127802 | Asa A. Peek | Obstetrics & Gynecology | 15 Riverbend Dr Sw, Ste 200, Rome, GA 30161-6065 | 2006-01-05 |
| 1447237169 | Dixon L Freeman | Obstetrics & Gynecology | 15 Riverbend Dr Sw, Ste 200, Rome, GA 30161-6065 | 2005-12-22 |
| 1083691703 | James H Vick IIi | Obstetrics & Gynecology | 15 Riverbend Dr Sw, Ste 200, Rome, GA 30161-6065 | 2005-12-22 |
| 1609853324 | Mary Catherine Burch | Nurse Practitioner | 15 Riverbend Dr Sw, Ste 100, Rome, GA 30161-6065 | 2005-12-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265069256 | Three Rivers Housing and Development Corporation | Chore Provider | 326 W. 9th St, Rome, GA 30161 | 2020-03-27 |
| 1144865957 | Eric Alan Fuller | Audiologist-Hearing Aid Fitter | 700 East 2nd Street, Suite C, Rome, GA 30161 | 2019-11-15 |
| 1003394883 | Cindy V Shelton | Health Educator | 204 E 1st Ave, Rome, GA 30161 | 2018-08-02 |
| 1083153597 | Julie Oglesby Allen | Counselor | 1 S Broad St Sw Ste 5, Rome, GA 30161 | 2017-02-16 |
| 1902299530 | Michael Thomas Phillips | Pharmacist | 2005 Maple Street, Rome, GA 30161 | 2015-03-06 |
| 1407259112 | Angela Smith | Community/Behavioral Health | 109 John Maddox Suite 200, Rome, GA 30161 | 2014-10-08 |
| 1215344379 | Nancy Patel | Pharmacist | 1421 North Broad St, Rome, GA 30161 | 2014-07-21 |
| 1821336629 | Wendy Pence | Nurse Practitioner | 3001 Turner Mccall Blvd, Rome, GA 30161 | 2013-01-29 |
| 1558526202 | Marilyn Teresa Ringstaff | Registered Nurse | 1513 Dean St., Rome, GA 30161 | 2008-07-22 |
| 1134310147 | Reneka L Dobbs-jackson | Family Medicine | 420 E 2nd Ave Ste 103, Rome, GA 30161 | 2007-08-05 |
| Find all providers in zip 30161 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821109919 | Alicia Mize Rix, Dmd PC | Dentist | 57 Three Rivers Dr Ne, Rome, GA 30161-4998 | 2006-08-31 |
| 1184735292 | Alicia M. Rix | Dentist | 57 Three Rivers Dr Ne, Rome, GA 30161-4998 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740895002 | Ashley Starnesdmd LLC | Dentist | 5482 Chamblee Dunwoody Rd Ste 9, Dunwoody, GA 30338-4142 | 2020-09-14 |
| 1912518531 | Samuel S Kwon - Athens Dmd PC | Dentist | 1795 Resurgence Drive, Suite 101, Watkinsville, GA 30677 | 2020-08-17 |
| 1366060618 | A Dental Home 4 Kidz | Dentist | 155 Carnegie Pl Ste 201, Fayetteville, GA 30214-3981 | 2020-07-13 |
| 1255973566 | Rehoboth Life Care Ministries, Inc | Dentist | 3208 Hwy 41, Byron, Byron, GA 31008 | 2019-10-09 |
| 1629619200 | Peachtree Hills Pediatric Dentistry | Dentist | 2385 Peachtree Rd Ne Ste A2ab, Atlanta, GA 30305-4139 | 2019-10-04 |
| 1871145557 | Dogwood Pediatric Dentistry of Statesboro, LLC | Dentist | 123 Hill Pond Ln, Statesboro, GA 30458-0872 | 2019-07-12 |
| 1952969396 | Ns3 Services, LLC | Dentist | 1039 Grant St Se Ste B11, Atlanta, GA 30315-2050 | 2019-05-31 |
| 1871050872 | Warner Robins Pediatric Dentistry LLC | Dentist | 102 S Houston Rd, Warner Robins, GA 31088-3904 | 2019-02-26 |
| 1730646886 | Smiles for Kids Norcross PC | Dentist | 3953 Holcomb Bridge Rd Ste 100, Peachtree Corners, GA 30092-5201 | 2019-02-25 |
| 1073083127 | Pediatric Dentistry of Central Georgia - Macon LLC | Dentist | 5437 Bowman Rd Ste 300, Macon, GA 31210-6575 | 2018-12-03 |
| Find all providers with the same taxonomy | ||||
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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.