DR. GIA SHAREE GRANNUM (NPI# 1700041639) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1700041639 |
Entity Type | Individual |
Full Name | DR. GIA SHAREE GRANNUM |
Other Name | GIA SHAREE SMITH |
Credential | DMD |
Practice Address |
3711 Lake Enclave Way Atlanta GA 30349-1891 |
Practice Telephone | 4043090349 |
Mailing Telephone | 4043090349 |
Enumeration Date | 2008-07-21 |
Last Update Date | 2016-08-23 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 122300000X | Dentist | 25502 | TX | Dental Providers |
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DN013924 | GA | Dental Providers |
N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
25502 | TX | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | 003121519 | 05 |
Street Address |
3711 LAKE ENCLAVE WAY |
City | ATLANTA |
State | GA |
Zip Code | 30349-1891 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376185686 | Kmb Diagnostics | Durable Medical Equipment & Medical Supplies | 941 Flat Shoals Rd, Atlanta, GA 30349 | 2019-10-09 |
1114575859 | Justin Vassell | Registered Nurse | 1903 Phoenix Boulevard, Suite 200, College Park, GA 30349 | 2019-08-27 |
1841856663 | Kennyetta Danielle Watkins | Counselor | 1431 Riverwalk Ln, Apt. F, College Park, GA 30349 | 2019-05-16 |
1275002636 | Patriot Healthcare of Georgia, LLC | Family Medicine | 1587 Phoenix Boulevard, Suite 6, College Park, GA 30349 | 2018-11-15 |
1669971875 | Ee Consulting Solution | Case Management | 6320 Topaz Tral, Arlanta, GA 30349 | 2018-02-03 |
1629595640 | Shayla Bouie | Contractor | 5420 Riverdale Rd Apt D17, Atlanta, GA 30349 | 2017-08-30 |
1114475563 | Jasmine V Mccully | Social Worker | 5864 Summergien Lane, College Park, GA 30349 | 2016-09-14 |
1639537681 | Shelia Thornton | Counselor | 5856 Seabright Lane, Atlanta, GA 30349 | 2016-02-05 |
1346610177 | Joanne Resilard | Nurse Practitioner | 2931 Herron Ln Sw, Atlanta, GA 30349 | 2015-10-06 |
1063805091 | Southwest Atlanta Medical & Rehabilitation Clinic LLC | Family Medicine | 495 85 Circle, Suite 100, Atlanta, GA 30349 | 2015-03-16 |
Find all providers in zip 30349 |
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 |
---|---|---|---|---|
1629619200 | Peachtree Hills Pediatric Dentistry | Dentist | 2385 Peachtree Rd Ne Ste A2ab, Atlanta, GA 30305-4139 | 2019-10-04 |
1952969396 | Ns3 Services, LLC | Dentist | 1039 Grant St Se Ste B11, Atlanta, GA 30315-2050 | 2019-05-31 |
1215336326 | Esther Lee | Dentist | 270 17th St Nw Unit 1706, Atlanta, GA 30363-1248 | 2014-08-14 |
1679993430 | Nikky Shotwell | Dentist | 2979 Silver Hill Ter., S.e., Atlanta, GA 30316-6715 | 2014-04-21 |
1932528577 | Jaha V Howard Dds LLC | Dentist | 4300 Paces Ferry Rd Se Ste 405, Atlanta, GA 30339-5759 | 2014-04-10 |
1790086668 | Dentistry for Children of Georgia LLC | Dentist | 1350 Spring St Nw Ste 600, Atlanta, GA 30309-2870 | 2010-11-09 |
1003123563 | Perimeter Pediatric Dentistry PC | Dentist | 2221 Johnson Ferry Rd Ne, Ste 2-a, Atlanta, GA 30319-2203 | 2010-09-07 |
1497905681 | David Michael Treff | Dentist | 4536 Chamblee Dunwoody Rd Ste 211, Atlanta, GA 30338-6201 | 2008-09-24 |
1780888693 | Teresa Danielle Jordan | Dentist | 2646 Gresham Rd Se, Atlanta, GA 30316-4148 | 2007-06-13 |
1659413953 | Ezat Mulki | Dentist | 1350 Spring St Nw, Ste 600, Atlanta, GA 30309-2864 | 2007-02-13 |
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.