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CREEKSIDE DENTISTRY LLC NPI 1558768770


NPI Information

NPI: 1558768770
Provider Name: CREEKSIDE DENTISTRY, LLC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
3238 KRISAM CREEK DR
LOGANVILLE, GA
ZIP 30052
Phone: (770) 466-0474
Get Directions

CREEKSIDE DENTISTRY, LLC is a general practice dentist in Loganville, GA. The provider is 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. CREEKSIDE DENTISTRY, LLC NPI is 1558768770. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3238 KRISAM CREEK DR
LOGANVILLE, GA
ZIP 30052-942
Phone: (770) 466-0474
Fax: (770) 466-3894

The provider's authorized official is Cyndi Simmons .
The authorized official title is Practice Manager and has the following contact phone number (770) 466-0474.

The enumeration date for this NPI number is 12/3/2014 and was last updated on 12/3/2014.


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
11223G0001XDentistGeneral PracticeGA8776GEORGIAYes

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

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