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FABULOUS SMILES OF LILBURN NPI 1205211133


NPI Information

NPI: 1205211133
Provider Name: FABULOUS SMILES OF LILBURN
Classification: Point of Service - 305S00000X
Entity Type: Organization
Address:
331 ARCADO RD NW
LILBURN, GA
ZIP 30047
Phone: (770) 557-0788
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FABULOUS SMILES OF LILBURN is a point of service in Lilburn, GA. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. FABULOUS SMILES OF LILBURN NPI is 1205211133. The provider is registered as an organization entity type.

The provider's business location address is:

331 ARCADO RD NW
LILBURN, GA
ZIP 30047-077
Phone: (770) 557-0788
Fax: (404) 420-2951

The provider's authorized official is Nikki Rolls .
The authorized official title is Office Manager and has the following contact phone number (770) 557-0788.

The enumeration date for this NPI number is 7/21/2015 and was last updated on 7/21/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1305S00000XPoint of ServiceDN011973GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.