CREEKSIDE DENTAL, INC. – NPI #1295561983
Clinic/Center

CREEKSIDE DENTAL, INC. is an AHC clinic located in DOUGLASVILLE, GA. NPPES has assigned the NPI number 1295561983 to CREEKSIDE DENTAL, INC. on September 10, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CREEKSIDE DENTAL, INC. below.

NPI Profile for
CREEKSIDE DENTAL, INC.

NPI Number
1295561983
Enumeration Date

(about 2 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CREEKSIDE DENTAL, INC.
Primary location
4904 TIMBER RIDGE DR STE 203
DOUGLASVILLE, GA 30135-1831
Phone: (770) 577-5727 Fax: (770) 577-7542
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
PAMELA DEAS
OFFICE MANAGER
Phone: (770) 577-5727
Updated
Certification Date
Sep 10, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.