CEDAR DENTAL CLINICAL I, LLC (NPI# 1740897776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740897776 |
| Entity Type | Organization |
| Organization Name | CEDAR DENTAL CLINICAL I, LLC |
| Practice Address |
3630 Thompson Bridge Rd Ste 18b Gainesville GA 30506-1524 |
| Mailing Address |
6801 Governors Lake Pkwy Ste 290 Peachtree Corners GA 30071-1136 |
| Practice Telephone | 6787694909 |
| Practice Fax Number | 6787694910 |
| Mailing Telephone | 6789783099 |
| Mailing Fax Number | 6786914425 |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2020-09-24 |
| Authorized Official Name | MR. HENRY RANKIN DALLAM III (PRESIDENT) |
| Authorized Official Telephone | 7703312529 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | GA DENTAL LICENSE | DNO13071 | 01 |
| Other Name | Type Code |
|---|---|
| Orthodontic Care of Georgia | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003423039 | Cedar Dental Clinical I, LLC | Dentist | 119 Willow Ln, Mcdonough, GA 30253-6574 | 2020-09-24 |
| 1073120002 | Cedar Dental Clinical I, LLC | Dentist | 494 Booth Rd Ste 1a, Warner Robins, GA 31088-3435 | 2020-09-24 |
| 1942817960 | Cedar Dental Clinical I, LLC | Dentist | 4272 Washington Rd Ste 7a, Evans, GA 30809-3073 | 2020-09-24 |
| 1366059396 | Cedar Dental Clinical I, LLC | Dentist | 18 Riverbend Dr Sw Ste 230, Rome, GA 30161-6019 | 2020-09-24 |
| 1790392710 | Cedar Dental Clinical I, LLC | Dentist | 6801 Governors Lake Pkwy Ste 290, Peachtree Corners, GA 30071-1136 | 2020-09-24 |
| Street Address |
3630 THOMPSON BRIDGE RD STE 18B |
| City | GAINESVILLE |
| State | GA |
| Zip Code | 30506-1524 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598325599 | Ride With Us Medical Transport LLC | Non-emergency Medical Transport (VAN) | 3877 C. Rogers Rd, Gainesville, GA 30506 | 2019-06-20 |
| 1437678950 | Thomas William Stewart Jr. | Pathology | 3138 Marthasville Court, Gainesville, GA 30506 | 2017-09-15 |
| 1629353461 | Finding Faith Inc | Physical Therapist | 7985 Knight Road, Suite B, Gainesville, GA 30506 | 2011-10-12 |
| 1992961296 | Georgia Cvs Pharmacy L.L.C. | Durable Medical Equipment & Medical Supplies | 3709 Thompson Bridge Rd., Gainesville, GA 30506 | 2008-08-06 |
| 1477754067 | Black's Pediatric Therapy, Inc. | Occupational Therapist | 4502 Summer Gate Ct., Gainesville, GA 30506 | 2007-05-30 |
| 1962535377 | Kim Kerrick | Physical Therapist | Lanier Village Estates, Misty Morning Way, Gainesville, GA 30506 | 2007-03-14 |
| 1942339098 | Lorie Miller Stevens | Dentist | 5129 Cleveland Hwy, Gainesville, GA 30506 | 2007-03-05 |
| 1972544963 | Christie L Woodruff | Nurse Practitioner | 4371 Clarks Bridge Road, Gainesville, GA 30506 | 2006-06-09 |
| 1336113919 | Alison K Zavodny | Internal Medicine | 4875 Perry Rd, Gainesville, GA 30506 | 2006-02-13 |
| 1497739429 | Anga-lee Morgan Tipton | Nurse Practitioner | 4000 Village View Drive, Gainesville, GA 30506 | 2005-12-02 |
| Find all providers in zip 30506 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952933541 | Katherine Kapernaros | Dentist | 1395 Center Dr Rm D7-35, Gainesville, FL 32610-3006 | 2020-02-11 |
| 1427610310 | Spencer Michael Mathews | Dentist | 1395 Center Dr Rm D7-19, Gainesville, FL 32610-3006 | 2019-07-01 |
| 1679015051 | Emmanuel Alfonso | Dentist | 3611 Sw 34th St Apt 230, Gainesville, FL 32608-6574 | 2016-11-16 |
| 1912303561 | Ron D. Wilson Dmd PC | Dentist | 1220 Sherwood Park Drive, Gainesville, GA 30501-3445 | 2014-11-10 |
| 1073749966 | Gainesville Orthodontic Associates | Dentist | 7504 Iron Bar Ln, Gainesville, VA 20155-2999 | 2009-06-05 |
| 1942475843 | Noelle Williams | Dentist | 3230 Sw Archer Rd, H242a, Gainesville, FL 32608-1700 | 2008-04-23 |
| 1164616272 | Madueke Ethelberth Ekoh | Dentist | 14634 Lee Highway, Gainesville, VA 20155 | 2007-08-31 |
| 1063623635 | Joseph March Waldron | Dentist | 611 Nw 60th St, Suite A, Gainesville, FL 32607-6029 | 2007-05-25 |
| 1942428446 | Reid Wallace Montini | Dentist | 7520 W University Ave Ste C, Gainesville, FL 32607-7612 | 2007-04-23 |
| 1740315399 | Enrique G Vargas | Dentist | 2841 Nw 41st St, Gainesville, FL 32606-6649 | 2007-02-23 |
| Find all providers in GAINESVILLE | ||||
| City | GAINESVILLE |
| Zip Code | 30506 |
Please comment or provide details below to improve the information on CEDAR DENTAL CLINICAL I, LLC.
| 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.