NPI 1255464384 · live from the CMS NPI Registry
Cumming Dental Associates
Dentist, General Practice in Cumming, GA. National Provider Identifier 1255464384, active.
NPI record
| NPI | 1255464384 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, General Practice 1223G0001X |
| Practice location | 1200 Bald Ridge Marina Rd, Suite 200, Cumming, GA 30041 |
| Practice phone | 770-781-8650 |
| Mailing address | Po Box 599, Cumming, GA 30028 |
| Enumerated | March 14, 2007 |
| Last updated | March 17, 2018 |
| Authorized official | Kevin Short, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist | 122300000X | DN014775 (GA) |
| Dentist | 122300000X | Dn015174 (GA) |
| Dentist | 122300000X | — |
| Dentist, General Practice | 1223G0001X | DN012306 (GA) |
| Dentist, General Practice | 1223G0001X | DN011760 (GA) |
| Dentist, General Practice | 1223G0001X | DN012514 (GA) |
| Dentist, General Practice | 1223G0001X | DN015212 (GA) |
| Dentist, Orthodontics and Dentofacial Orthopedics | 1223X0400X | DN011424 (GA) |
| Dentist, General Practice primary | 1223G0001X | DN011242 (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.