PALMETTO FAMILY DENTAL OF PIKE COUNTY (NPI# 1780017822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780017822 |
| Entity Type | Organization |
| Organization Name | PALMETTO FAMILY DENTAL OF PIKE COUNTY |
| Other Organization Name | PALMETTO FAMILY DENTAL |
| Practice Address |
15988 Barnesville St. Zebulon GA 30295 |
| Practice Telephone | 7705678000 |
| Practice Fax Number | 7705678600 |
| Mailing Telephone | 7705678000 |
| Mailing Fax Number | 7705678600 |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2013-08-13 |
| Authorized Official Name | DR. JORDAN ALBERT BRUNSON (PRESIDENT) |
| Authorized Official Telephone | 7705678000 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
DN013693 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 685019718C | 05 |
| Other Name | Type Code |
|---|---|
| Palmetto Family Dental | Doing Business As Name - Organization |
| Street Address |
15988 BARNESVILLE ST. |
| City | ZEBULON |
| State | GA |
| Zip Code | 30295 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144842352 | Kelli Kaczmarek | Counselor | 9829 Us-19, Zebulon, GA 30295 | 2020-05-11 |
| 1730710914 | Servemed, Inc | Pharmacy | 10263 Us Hwy 19, Suite 226, 226 Plaza Drive, Zebulon, GA 30295 | 2020-01-28 |
| 1497134308 | Eva White | Nurse Practitioner | 1070 County Farm Rd, Williamson, GA 30295 | 2015-05-26 |
| 1043352271 | Kenneth David Gaskins | Pharmacist | 119 Concord Street, Zebulon, GA 30295 | 2007-02-13 |
| 1497821862 | Donna Michelle Haney | Family Medicine | 16125 Barnesville Street, Zebulon, GA 30295 | 2006-11-28 |
| 1669543476 | Pike County Board of Education | Local Education Agency (LEA) | 115 West Jackson Street, Zebulon, GA 30295 | 2006-11-13 |
| 1457440364 | Pike County Health Department | Registered Nurse | 541 Griffin Street, Zebulon, GA 30295 | 2006-10-11 |
| 1346353919 | Frank W. Kirby | Dentist | 7233 Us Highway 19, Zebulon, GA 30295 | 2006-08-16 |
| 1417941998 | Pike County Health Department | Public Health or Welfare | 541 Griffin Str., Zebulon, GA 30295 | 2005-09-09 |
| 1093255481 | Jessica Ridgeway | Marriage & Family Therapist | 1070 County Farm Rd, Zebulon, GA 30295 | 2017-03-03 |
| Find all providers in zip 30295 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922606490 | Smile Pleasant Hill LLC | Clinic/Center | 828 Pleasant Hill Rd Nw Ste 10, Lilburn, GA 30047-2757 | 2020-10-15 |
| 1982213583 | Munoz Dental Resources LLC | Clinic/Center | 4141 Steve Reynolds Blvd Ste 1, Norcross, GA 30093-3060 | 2020-07-29 |
| 1407474794 | Familia Dentistry of Georgia, LLC | Clinic/Center | 4574 Lawrenceville Hwy Nw Ste 120r, Lilburn, GA 30047-3605 | 2020-07-13 |
| 1336763648 | Bethlehem Orthodontics | Clinic/Center | 426 Exchange Blvd Ste 400, Bethlehem, GA 30620-1791 | 2020-06-02 |
| 1770106882 | Smiles By Dixon PC | Clinic/Center | 690 Lanier Park Dr, Gainesville, GA 30501-2061 | 2020-05-22 |
| 1811516479 | Mouthpeace Dental 4, LLC | Clinic/Center | 541 Forest Pkwy Ste 18, Forest Park, GA 30297-6110 | 2020-04-14 |
| 1427677541 | Mh Dental Group, LLC | Clinic/Center | 1305 Cedarcrest Rd Ste 115, Dallas, GA 30132-8201 | 2020-04-09 |
| 1104451160 | Sno Healthcare Group | Clinic/Center | 2424 Roswell Rd Ste 120, Marietta, GA 30062 | 2020-03-10 |
| 1952935710 | West Cobb Periodontics and Implant Dentistry LLC | Clinic/Center | 44 Old Hamilton Rd Nw Ste 200, Marietta, GA 30064-5901 | 2020-03-02 |
| 1659904241 | Dental Now Kids LLC | Clinic/Center | 4151 Steve Reynolds Blvd Ste 2, Norcross, GA 30093-3060 | 2020-02-21 |
| 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.