TRINITY ORTHODONTICS OF FAYETTEVILLE LLC (NPI# 1972972685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1972972685 |
Entity Type | Organization |
Organization Name | TRINITY ORTHODONTICS OF FAYETTEVILLE LLC |
Practice Address |
719 Lanier Ave W Ste B Fayetteville GA 30214-7621 |
Practice Telephone | 4046966595 |
Mailing Telephone | 4046966595 |
Enumeration Date | 2015-09-23 |
Last Update Date | 2015-09-23 |
Authorized Official Name | DR. PAUL MCKOY (CFO) |
Authorized Official Telephone | 4046966595 |
Authorized Official Credential | DDS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers |
Street Address |
719 LANIER AVE W STE B |
City | FAYETTEVILLE |
State | GA |
Zip Code | 30214-7621 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508316472 | Transition Therapy Solutions | Speech-Language Pathologist | 719 Lanier Ave W Ste B, Fayetteville, GA 30214-7621 | 2016-10-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
Find all providers in zip 30214 |
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 |
---|---|---|---|---|
1578001616 | Jesse R Gray Dds Pa | Dentist | 3119 E Mission Blvd, Fayetteville, AR 72703-6617 | 2017-02-09 |
1386048189 | Bethel Burris Oliver Pllc | Dentist | 2901 Zion Rd, Fayetteville, AR 72703-5007 | 2014-10-22 |
1083957351 | Gateway Ventures LLC | Dentist | 3782 N Front St, Suite 1, Fayetteville, AR 72703-5128 | 2013-04-04 |
1780995449 | Gregory J Stock | Dentist | 404 E Genesee St, Fayetteville, NY 13066-1503 | 2010-06-28 |
1003019845 | Dana Thi Tang | Dentist | 2997 Hope Mills Rd Ste C, Fayetteville, NC 28306-8349 | 2007-06-08 |
1326256066 | Eric J. Echols | Dentist | 102 Pavilion Pkwy, Suite 14, Fayetteville, GA 30214-4056 | 2007-05-18 |
1033325436 | Darrin Storms D.d.s., C.a.g.s., P.a. | Dentist | 4102 N Mall Ave Ste 101, Fayetteville, AR 72703-4929 | 2007-05-15 |
1962623819 | J. Spencer Boley | Dentist | 4501 W Wedge Dr, Fayetteville, AR 72704-7532 | 2007-05-01 |
1992864375 | Michael W Granger | Dentist | 745 Bradley Dr, Fayetteville, GA 30214-2030 | 2006-12-08 |
1922166610 | Bill Pickard, Dds, Ms, Pa | Dentist | 3533 N Shiloh Dr Ste 3, Fayetteville, AR 72703-5317 | 2006-12-05 |
Find all providers in FAYETTEVILLE |
City | FAYETTEVILLE |
Zip Code | 30214 |
Please comment or provide details below to improve the information on TRINITY ORTHODONTICS OF FAYETTEVILLE LLC.
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.