PINE MOUNTAIN FAMILY DENTISTRY, LLC


Address: 8944 Hamilton Road, Pine Mountain, GA 31822
Phone: 7066632272

PINE MOUNTAIN FAMILY DENTISTRY, LLC (NPI# 1780915165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1780915165
Entity Type Organization
Organization Name PINE MOUNTAIN FAMILY DENTISTRY, LLC
Practice Address 8944 Hamilton Road
Pine Mountain
GA 31822
Mailing Address P.o. Box 1176
Pine Mountain
GA 31822-4707
Practice Telephone 7066632272
Practice Fax Number 7066632075
Mailing Telephone 7066632272
Mailing Fax Number 7066632075
Enumeration Date 2010-01-25
Last Update Date 2010-01-25
Authorized Official Name DR. SIDNEY DAUSTER HARDEN III (DENTIST)
Authorized Official Telephone 7066632272
Authorized Official Credential D.M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 122300000X Dentist DNO08005 GA Dental Providers
Y 122300000X Dentist DNO12733 GA Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
GA 000045295A 05
GA 594312970B 05

Office Location

Street Address 8944 HAMILTON ROAD
City PINE MOUNTAIN
State GA
Zip Code 31822

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1871898676 Steve Earles Physical Therapist 1514 Piedmont Lake Road, Pine Mountain, GA 31822 2011-01-26
1194857813 Timothy Turco Psychologist 107 Broad St., Pine Mountain, GA 31822 2007-03-09
1417944075 Chattahoochee Valley Hospital Society Home Health Us Hwy 27 and 354, 5700 Chipley Village, Pine Mountain, GA 31822-0475 2005-09-29
1447280672 Pine Mountain Pharmacy, Inc Pharmacy 145 N Main Ave, Pine Mountain, GA 31822-0500 2006-07-04
1255331351 Mack H Clements Family Medicine 211 East Broad St, Pine Mountain, GA 31822-0516 2005-07-29
1801083134 Clements Professional Association Pine Mountain General Practice 211 East Broad St, Pine Mountain, GA 31822-0516 2007-10-01
1700859840 Grady Glenn Barnwell Jr. Obstetrics & Gynecology 217 W Harris St, Pine Mountain, GA 31822-1149 2006-02-09
1538382171 Pine Mountain Eye Care Optometrist 414 S Main Ave, Pine Mountain, GA 31822-2355 2007-04-11
1427122951 Jeffery A. Russell Chiropractor 624 N Main Ave, Pine Mountain, GA 31822-2403 2006-11-17
1023201217 Pine Mountain Chiropractic Center, LLC Clinic/Center 624 N Main Ave, Pine Mountain, GA 31822-2403 2007-08-22
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Taxonomy Information

Taxonomy Code 122300000X
Grouping Dental Providers
Classification Dentist

Taxonomy Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1154920445 Islands Family Dental, LLC Dentist 3 Wilmington Village Way, Savannah, GA 31410-3700 2020-10-19
1528665486 Mount Vernon Dental Group, LLC Dentist 2472 Jett Ferry Rd Ste 430, Dunwoody, GA 30338-3059 2020-10-05
1144835570 Affordable Dentures & Implants of Georgia II, LLC Dentist 3675 Satellite Blvd Ste 700, Duluth, GA 30096-2309 2020-09-11
1164037800 Darby Kathryn Gentry Dentist 3585 Lawrenceville Suwanee Rd # 101-a, Suwanee, GA 30024-7058 2020-09-10
1437763380 Ah Chong Dentist 755 Commerce Dr Ste 513, Decatur, GA 30030-2618 2020-09-08
1992319271 Jillian Nicole Felton Dentist 4070 Lavista Rd Ste 102, Tucker, GA 30084-5228 2020-09-03
1295347748 Elizabeth W Muraya Dentist 5218 Jimmy Lee Smith Pkwy Ste 100, Hiram, GA 30141-2747 2020-08-17
1942818182 Prasanthi Pattabhi Dentist 2993 Normandy Rdg, Lawrenceville, GA 30044-7869 2020-07-14
1700404522 Rocio Jacobo Rubio Dentist 23 Old Atlanta Hwy Ste 200, Newnan, GA 30263-6341 2020-07-08
1265059364 Abboss Sharifzadeh Dentist 4090 Jiles Rd Nw, Kennesaw, GA 30144-1105 2020-07-06
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Competitor

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City PINE MOUNTAIN
Zip Code 31822

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Dataset Information

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.

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