CEDAR DENTAL CLINICAL I, LLC (NPI# 1942817960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942817960 |
| Entity Type | Organization |
| Organization Name | CEDAR DENTAL CLINICAL I, LLC |
| Practice Address |
4272 Washington Rd Ste 7a Evans GA 30809-3073 |
| Mailing Address |
6801 Governors Lake Pkwy Ste 290 Peachtree Corners GA 30071-1136 |
| Practice Telephone | 7066217586 |
| Practice Fax Number | 7066217586 |
| 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 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | GA DENTAL LICENSE | DNO13071 | 01 |
| Other Name | Type Code |
|---|---|
| Orthodontic Care of Georgia | Doing Business As Name - Organization |
| 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 |
| 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 |
| 1790392710 | Cedar Dental Clinical I, LLC | Dentist | 6801 Governors Lake Pkwy Ste 290, Peachtree Corners, GA 30071-1136 | 2020-09-24 |
| Street Address |
4272 WASHINGTON RD STE 7A |
| City | EVANS |
| State | GA |
| Zip Code | 30809-3073 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326674060 | Dominion Behavioral Health Services LLC | Psychiatric Unit | 817 Prairie Lane, Evans, GEORGIA 30809 | 2020-03-13 |
| 1710478102 | Georgia Dental Professionals, PC | Dentist | 5131 Washington Rd, Evans, GA 30809 | 2018-05-22 |
| 1649770678 | Angel Legare | Physician Assistant | 404 Town Park Blvd Ste 101, Evans, GA 30809 | 2018-02-16 |
| 1952829541 | Felicia Evette Rhodes | Home Health Aide | 715 Jones Creek, Evans, GA 30809 | 2017-09-02 |
| 1659733582 | Patricia J. Stewart Lpc, LLC | Counselor | 465 N. Belair Rd. Ste 2d, Evans, GA 30809 | 2016-03-21 |
| 1114306727 | John Mccaskey | Family Medicine | 465 N Belair Rd Ste 1b, Evans, GA 30809 | 2015-05-28 |
| 1053702878 | Jennifer Wahl | Assistant Behavior Analyst | 1135 Waltons Pass, Evans, GA 30809 | 2015-02-16 |
| 1609298777 | Custom Pharmacy, Inc | Pharmacy | 1202 Town Park Lane, Suite 200, Evans, GA 30809 | 2014-01-09 |
| 1457797938 | Perfect Health Always On Call, LLC | Non-Pharmacy Dispensing Site | 4244 Washington Rd, Evans, GA 30809 | 2013-05-11 |
| 1417207119 | Tommy Battle | Respiratory Therapist, Registered | 101 Pond View, Evans, GA 30809 | 2012-09-11 |
| Find all providers in zip 30809 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255646022 | Paul Griffis Trotter | Dentist | 4101 Amberley Trl, Evans, GA 30809-5519 | 2010-08-17 |
| 1417971250 | R. Steven Powell Sr. | Dentist | 625 Ronald Reagan Dr, Evans, GA 30809-7602 | 2006-07-26 |
| 1104075118 | Eugene Harry Williamson | Dentist | 4250 Washington Rd, Evans, GA 30809 | 2008-09-15 |
| 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 |
| 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 |
| 1790392710 | Cedar Dental Clinical I, LLC | Dentist | 6801 Governors Lake Pkwy Ste 290, Peachtree Corners, GA 30071-1136 | 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 | ||||
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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.