CEDAR DENTAL CLINICAL I, LLC


Address: 6801 Governors Lake Pkwy Ste 290, Peachtree Corners, GA 30071-1136
Phone: 6789783099

CEDAR DENTAL CLINICAL I, LLC (NPI# 1790392710) 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) 1790392710
Entity Type Organization
Organization Name CEDAR DENTAL CLINICAL I, LLC
Other Organization Name ORTHODONTIC CARE OF GEORGIA
Practice Address 6801 Governors Lake Pkwy Ste 290
Peachtree Corners
GA 30071-1136
Practice Telephone 6789783099
Practice Fax Number 6786914425
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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223X0400X Dentist
Specialization: Orthodontics and Dentofacial Orthopedics
Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
GA GA DENTAL LICENSE DNO13071 01

Other Provider/Organization Names

Other Name Type Code
Orthodontic Care of Georgia Doing Business As Name - Organization

Other Provider IDs and Locations

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
1740897776 Cedar Dental Clinical I, LLC Dentist 3630 Thompson Bridge Rd Ste 18b, Gainesville, GA 30506-1524 2020-09-24

Office Location

Street Address 6801 GOVERNORS LAKE PKWY STE 290
City PEACHTREE CORNERS
State GA
Zip Code 30071-1136

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1477199867 1st Senior Cares, LLC Home Health 7116 Peachtree Industrial Blvd. Bldg. 4, Ste. B, Peachtree Corners, GA 30071 2019-11-21
1124660048 Phil Scafidi Massage Therapist 50 Skin Alley, Norcross, GA 30071 2019-10-11
1063071454 Kenanesha Owens Counselor 3040 Holcolmb Bridge Rd Suite J2, Norcross, GA 30071 2019-06-10
1407318389 1st Senior Homecare, LLC Home Health 7116 Peachtree Industrial Blvd., Bldg 4 Suite A, Peachtree Corners, GA 30071 2019-04-01
1982163689 Jk Acupuncture LLC Acupuncturist 5390 Peachtree Industrial Bl #101, Norcross, GA 30071 2019-03-13
1063990778 First Senior Center Clinic/Center 7116 Peachtree Industrial Blvd, Bldg 4, Peachtree Corners, GA 30071 2018-08-03
1952896904 Sonal P Patel Physical Therapy Assistant 4709 Peachtree Ind Blvd, Suite 106, Norcross, GA 30071 2018-06-22
1700392354 Medlink Ems Inc Ambulance 6825 Jimmy Carter Blvd Ste 1303, Norcross, GA 30071 2017-12-19
1205377975 David Kalisz II Specialist/Technologist, Other 1880 Beaver Ridge Circle Suite D, Norcross, GA 30071 2017-03-15
1356792519 Tiffany Pope Counselor 6045 Atlantic Blvd Ste 108, Norcross, GA 30071 2016-06-28
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Taxonomy Information

Taxonomy Code 1223X0400X
Grouping Dental Providers
Classification Dentist
Specialization Orthodontics and Dentofacial Orthopedics

Taxonomy Definition

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.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1144828765 Sharma Orthodontics LLC Dentist 3535 Roswell Rd Ste 53, Marietta, GA 30062-8828 2020-10-15
1700484094 Beltway Orthodontics Dentist 857 Collier Rd Nw Ste 5a-5b, Atlanta, GA 30318-2532 2020-10-09
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
1740897776 Cedar Dental Clinical I, LLC Dentist 3630 Thompson Bridge Rd Ste 18b, Gainesville, GA 30506-1524 2020-09-24
1598379679 Dr. Milan Dhanani PC Dentist 1905 Beaver Ruin Rd Ste 175b, Norcross, GA 30071-3837 2020-09-04
1316584758 Classic City Orthodontics, LLC Dentist 1020 Jamestown Blvd Bldg 100, Watkinsville, GA 30677-4131 2019-12-04
1952957714 Melisa Stewart Dentist 5555 Peachtree Dunwoody Rd Ste 301, Atlanta, GA 30342-1712 2019-08-16
Find all providers with the same taxonomy

Competitor

Search similar providers

City PEACHTREE CORNERS
Zip Code 30071

Improve Information

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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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