PALMETTO FAMILY DENTAL – NPI #1780017822
Clinic/Center

PALMETTO FAMILY DENTAL is an AHC clinic located in ZEBULON, GA. NPPES has assigned the NPI number 1780017822 to PALMETTO FAMILY DENTAL on August 13, 2013. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “PALMETTO FAMILY DENTAL” is a dba name, the actual legal business name for this organization is PALMETTO FAMILY DENTAL OF PIKE COUNTY. 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

The NPI profile was previously updated about 4 years ago on Jul 20, 2022. 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 PALMETTO FAMILY DENTAL below.

NPI Profile for
PALMETTO FAMILY DENTAL OF PIKE COUNTY

NPI Number
1780017822
Enumeration Date

(about 13 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
PALMETTO FAMILY DENTAL OF PIKE COUNTY
Doing Business As (dba): PALMETTO FAMILY DENTAL
Primary location
15988 BARNESVILLE ST.
ZEBULON, GA 30295
Phone: (770) 567-8000 Fax: (770) 567-8600
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JORDAN BRUNSON
PRESIDENT
Phone: (770) 567-8000
Updated
Certification Date
Jul 20, 2022

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.

Identifiers

Identifiers for PALMETTO FAMILY DENTAL

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDGA685019718C
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)		 GA DN013693

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.