INDIANA DENTAL CLINIC PC (NPI# 1790888170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790888170 |
| Entity Type | Organization |
| Organization Name | INDIANA DENTAL CLINIC PC |
| Other Organization Name | ATLANTA DENTAL CLINIC |
| Practice Address |
29101 St Rd 19 Atlanta IN 46031 |
| Mailing Address |
Po Box 186 Atlanta IN 46031 |
| Practice Telephone | 7652922366 |
| Practice Fax Number | 7652922081 |
| Mailing Telephone | 7652922366 |
| Mailing Fax Number | 7652922081 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. FENNIS BLEDSOE (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 7652922366 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Atlanta Dental Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952404337 | Indiana Dental Clinic PC | Dentist | 615 W Commerce St, Brownstown, IN 47220 | 2006-09-07 |
| Street Address |
29101 ST RD 19 |
| City | ATLANTA |
| State | IN |
| Zip Code | 46031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609979061 | Jami Lynn Warner | Dentist | 29101 St Rd 19, Atlanta, IN 46031 | 2006-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417997032 | New Hope of Indiana, Inc. | Intermediate Care Facility, Mental Illness | 130 E Meridian St, Atlanta, IN 46031-9210 | 2006-06-08 |
| 1801409453 | Alicia Lorene Howard | Speech-Language Pathologist | 29101 N State Road 19, Atlanta, IN 46031-9443 | 2020-08-24 |
| 1225376247 | Adam Edmonds | Community Health Worker | 3170 W 600 S, Atlanta, IN 46031-9583 | 2013-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841038 | Kathryn Louis | Doula | 301 Atlanta Ave Se Apt 5, Atlanta, GA 30315-2037 | 2020-11-08 |
| 1477154110 | Christina Danielle Palau Vaccari | Nurse Practitioner | 712 Pasley Ave Se, Atlanta, GA 30316-2158 | 2020-11-07 |
| 1902407752 | Neighbormd of Atlanta LLC | Internal Medicine | 285 Boulevard Ne Ste 435&436, Atlanta, GA 30312-4205 | 2020-11-06 |
| 1053912907 | Neighbormd of North Atlanta LLC | Internal Medicine | 1800 Peachtree St Nw Ste 730nw, Atlanta, GA 30309-2519 | 2020-11-06 |
| 1285235036 | Neighbormd of South Atlanta LLC | Internal Medicine | 3885 Princeton Lakes Way Sw Ste 412, Atlanta, GA 30331-5599 | 2020-11-06 |
| 1073114286 | Sadiecare Health Services Incorporated | Home Health | 483 Holderness St Sw Unit B, Atlanta, GA 30310-1748 | 2020-11-04 |
| 1588265839 | Mina Xia | Dietitian, Registered | 7007 Kingswood Run Dr, Atlanta, GA 30340-1865 | 2020-11-03 |
| 1790386258 | Thrive Orthopaedics LLC | Orthopaedic Surgery | 5775 Peachtree Dunwoody Rd Ne Ste C150a, Atlanta, GA 30342-1501 | 2020-11-02 |
| 1811597461 | Nanoresearch, Inc | Point of Service | 58 Edgewood Ave Ne, Suite 122, Collabtech., Gsu, Atlanta, GA 30303 | 2020-10-31 |
| 1356941082 | Just Peachy Home Care LLC | Home Health | 550 Fairburn Rd Sw Ste B1, Atlanta, GA 30331-2016 | 2020-10-30 |
| Find all providers in ATLANTA | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568079143 | Bimala Gharti | Dentist | 7310 Village Creek Trce, Atlanta, GA 30328-6763 | 2020-09-28 |
| 1699385062 | Hetal Trivedi | Dentist | 930 Spring St Nw Unit 915-a, Atlanta, GA 30309-3816 | 2020-07-31 |
| 1013548577 | Dental Care 24 7 Staffing Atlanta, LLC | Dentist | 285 Centennial Olympic Park Dr Nw # Cu-2b, Atlanta, GA 30313-1834 | 2020-02-03 |
| 1013547173 | Sha-vashtiy Young-ufeli | Dentist | 587 Virginia Ave Ne Unit 5, Atlanta, GA 30306-3695 | 2020-01-16 |
| 1588210207 | Edgewood Smiles Dentistry, PC | Dentist | 144 Moreland Ave Ne Ste A, Atlanta, GA 30307-2660 | 2019-08-19 |
| 1912552464 | Casey Jean Shuster | Dentist | 999 Peachtree St Ne Ste 715, Atlanta, GA 30309-3964 | 2019-08-01 |
| 1306404389 | Gabrielle Coe | Dentist | 205 S Race St, Atlanta, IL 61723-7586 | 2019-06-04 |
| 1417513730 | Jordan Alexander Reznik | Dentist | 236 Perimeter Center Pkwy Ne Ste C-30, Atlanta, GA 30346-1402 | 2019-05-13 |
| 1316419666 | Vbdc of Woodstock, LLC | Dentist | 5909 Peachtree Dunwoody Rd Ste 800, Atlanta, GA 30328-8103 | 2018-12-27 |
| 1487136867 | Abby Lynn Halpern | Dentist | 1080 Peachtree St Ne Unit 2604, Atlanta, GA 30309-6836 | 2018-09-03 |
| Find all providers in ATLANTA | ||||
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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.