Provider Type Icon

BROOKHAVEN VILLAGE DENTISTRY NPI 1508540196


NPI Information

NPI: 1508540196
Provider Name: BROOKHAVEN VILLAGE DENTISTRY
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

CLIA Number: 11D2274412

Address:
2814 BUFORD HWY NE
BROOKHAVEN, GA
ZIP 30329
Phone: (404) 683-2444
Get Directions

BROOKHAVEN VILLAGE DENTISTRY is a dental clinic center in Brookhaven, GA. BROOKHAVEN VILLAGE DENTISTRY NPI is 1508540196. The provider is registered as an organization entity type.

The provider's business location address is:

2814 BUFORD HWY NE
BROOKHAVEN, GA
ZIP 30329-103
Phone: (404) 683-2444

The provider's authorized official is Myra Scarlett .
The authorized official title is Dentist and has the following contact phone number (404) 683-2444.

The CLIA number assigned to this NPI record is 11D2274412 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/14/2023 and was last updated on 6/14/2023.


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
1261QD0000XClinic/CenterDentalYes

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.