CAMP CREEK SMILES FAMILY DENTISTRY (NPI# 1770811713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770811713 |
| Entity Type | Organization |
| Organization Name | CAMP CREEK SMILES FAMILY DENTISTRY |
| Practice Address |
3890 Redwine Rd Sw Ste 108 Atlanta GA 30331-5582 |
| Practice Telephone | 4043447645 |
| Practice Fax Number | 4046962883 |
| Mailing Telephone | 4043447645 |
| Mailing Fax Number | 4046962883 |
| Enumeration Date | 2009-12-03 |
| Last Update Date | 2009-12-03 |
| Authorized Official Name | DR. PAUL R MCKOY (DENTIST) |
| Authorized Official Telephone | 4043447645 |
| Authorized Official Credential | DDS |
| 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 |
3890 REDWINE RD SW STE 108 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30331-5582 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588659908 | Dara Paul | Specialist | 3890 Redwine Rd Sw, Ste 210, Atlanta, GA 30331-5509 | 2005-09-12 |
| 1538616305 | Marion Bianca Tyson | Physical Therapist | 3890 Redwine Rd Sw, Suite 114, Atlanta, GA 30331-5582 | 2016-09-08 |
| 1871853606 | Paddyson Chukwuka Chidi | Physical Therapist | 3890 Redwine Rd Sw, Suite 114, Atlanta, GA 30331-5582 | 2012-05-27 |
| 1447529342 | Pain Management of The South | Anesthesiology | 3890 Redwine Rd Sw, Suite 200, Atlanta, GA 30331-5582 | 2011-12-21 |
| 1487957924 | Pinnacle Diagnostic and Dme Services, LLC | Durable Medical Equipment & Medical Supplies | 3890 Redwine Rd Sw, Suite 200, Atlanta, GA 30331-5582 | 2010-12-06 |
| 1598072910 | Willis C Jenkins | Physical Therapy Assistant | 3890 Redwine Rd Sw, Suite 114, Atlanta, GA 30331-5582 | 2010-09-07 |
| 1184939456 | Accident Centers of Atlanta, LLC | Durable Medical Equipment & Medical Supplies | 3890 Redwine Rd Sw, Suite 200, Atlanta, GA 30331-5582 | 2010-08-11 |
| 1922269612 | Camp Creek Pediatrics LLC | Clinic/Center | 3890 Redwine Rd Sw, Suite 100, Atlanta, GA 30331-5582 | 2008-06-24 |
| 1700072485 | Premier Eye Physicians PC | Clinic/Center | 3890 Redwine Rd Sw, Suite 212, Atlanta, GA 30331-5582 | 2007-09-17 |
| 1861600520 | Genesis Sports Medicine and Rehabilitation, LLC | Clinic/Center | 3890 Redwine Rd Sw, Atlanta, GA 30331-5582 | 2007-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861001174 | Whitney Flemister | Social Worker | 3961 Princeton Lakes Way Sw, Atlanta, GA 30331 | 2020-07-23 |
| 1982237400 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 5829 Campbellton Road, S.w, Suite 110, Atlanta, GA 30331 | 2020-02-13 |
| 1295375558 | Drusilla Precious Cudjoe | Behavior Technician | 3800 Camp Creek Parkway Sw, Building 1400, Atlanta, GA 30331 | 2020-01-14 |
| 1497262778 | Champions Pharmacy | Pharmacy | 3886 Princeton Lakes Way Suite 180, Atlanta, GA 30331 | 2018-01-08 |
| 1033629779 | Carmen Ardoin | Counselor | 2636 Martin Luther King Jr. Drive, Suite 12, Atlanta, GA 30331 | 2017-10-09 |
| 1346759974 | Neva R Allison | Nurse Practitioner | 2611 Dayview Ln, Atlanta, GA 30331 | 2017-09-26 |
| 1538678255 | Natalie Mckay | Technician/Technologist | 3915 Cascade Rd, 220, Atlanta, GA 30331 | 2017-09-26 |
| 1700304268 | Tyrone Pipkin | Contractor | 415 Kendrick Terrace Sw, Atlanta, GA 30331 | 2017-09-05 |
| 1073031688 | Kristen Wooldridge | Pharmacist | 3695 Cascade Road, Atlanta, GA 30331 | 2017-09-04 |
| 1548704687 | Advance Pain Management | Health Maintenance Organization | 2950 Stone Hogan Road Connector, Atlanta, GA 30331 | 2016-12-08 |
| Find all providers in zip 30331 | ||||
| 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 |
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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.