PEACH DENTAL LLC (NPI# 1528672417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528672417 |
| Entity Type | Organization |
| Organization Name | PEACH DENTAL LLC |
| Practice Address |
236 Perimeter Center Pkwy Ne Ste C-30 Atlanta GA 30346-1402 |
| Practice Telephone | 4046253009 |
| Mailing Telephone | 4046253009 |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2020-09-08 |
| Authorized Official Name | DR. JORDAN ALEXANDER REZNIK (DENTIST) |
| Authorized Official Telephone | 4044061251 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
236 PERIMETER CENTER PKWY NE STE C-30 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30346-1402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417513730 | Jordan Alexander Reznik | Dentist | 236 Perimeter Center Pkwy Ne Ste C-30, Atlanta, GA 30346-1402 | 2019-05-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730694332 | Man Fung Lam | Behavioral Analyst | 302 Perimeter Ctr N Apt 2431, Atlanta, GA 30346 | 2017-12-05 |
| 1518413897 | Terre Cheely | Nurse Practitioner | 2 Ravinia Drive Suite 500, Atlanta, GA 30346 | 2016-08-28 |
| 1790139954 | Rachel Brandeis | Dietitian, Registered | 400 Perimeter Center Terrace North, Suite 900, Atlanta, GA 30346 | 2016-04-14 |
| 1952778441 | Kaitlyn Victoria Fredrick | Nurse Practitioner | 41 Perimeter Ctr E Ste 250, Dunwoody, GA 30346 | 2015-08-31 |
| 1689917965 | Taryn Abrams | Psychiatry & Neurology | 41 Perimeter Center East, Suite 250, Dunwoody, GA 30346 | 2013-04-04 |
| 1154683381 | Coby John Lund | Behavioral Analyst | 53 Perimeter Center East, Suite 350, Atlanta, GA 30346 | 2012-06-13 |
| 1306113832 | Shannah Melanie Bachar | Behavioral Analyst | 53 Perimeter Center East Suite 350, Atlanta, GA 30346 | 2011-11-29 |
| 1740561125 | Jblb Holdings, LLC | Electrodiagnostic Medicine | 400 Perimeter Center Ter North, Suite 900, Atlanta, GA 30346 | 2011-08-30 |
| 1215109996 | Alphonso D Porter | Technician/Technologist | 3118-a Washington Rd, East Point, GA 30346 | 2008-04-02 |
| 1437275005 | Elaine Gilner Friedman | Social Worker | 12234 Madison Drive, Atlanta, GA 30346 | 2007-03-22 |
| Find all providers in zip 30346 | ||||
| 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.