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PAUL IVEY NETTLES LLC
NPI 1063564078
Dentist - Pediatric Dentistry in College Park, GA

Active since January 18, 2007
1177 GARDEN WALK BLVD, COLLEGE PARK, GA 30349(770) 997-9090 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Paul Ivey Nettles Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PAUL IVEY NETTLES LLC (NPI 1063564078) is a healthcare organization registered as a pediatric dentistry in College Park, Georgia and active in the NPI registry since January 2007. The organization lists Paul I Nettles, President, as its authorized official.

NPPES Registry Identity

NPI1063564078
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NamePAUL IVEY NETTLES LLC
Location Address1177 GARDEN WALK BLVDCollege Park, GA 30349-6245
Mailing Address730 Highmeade TerAlpharetta, GA 30005-3755 · (770) 337-0976
Phone(770) 997-9090
Organization SubpartNo
Authorized OfficialPaul I NettlesPresident · (770) 997-9090
Enumeration DateJanuary 18, 2007
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
✔ NPI 1063564078 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in GA · 6742
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Also ListedDentist · General PracticeTaxonomy 1223G0001X · License 11589 (GA)
1177 GARDEN WALK BLVD, College Park, GA 30349
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Other Identifiers 1

Medicaid0050949AGA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ALEX CHRISTOPHER HARVEY D.M.D.
Dentist
1177 GARDEN WALK BLVD
COLLEGE PARK, GA 30349
Fulton County (770) 997-9090
DR. ALAN B GOLDMAN
Dentist (Pediatric Dentistry)
1177 GARDEN WALK BLVD
COLLEGE PARK, GA 30349
Fulton County (770) 997-9090
DR. EDMOND MICHAEL FRANKLIN DDS
Dentist
1177 GARDEN WALK BLVD
COLLEGE PARK, GA 30349
Fulton County (770) 997-9090
VIVID SMILE DENTAL CENTER
Dentist (General Practice)
1177 GARDEN WALK BLVD
COLLEGE PARK, GA 30349
Fulton County (770) 997-9090
DHARMESH PARBHOO P.C.
Clinic/Center (Dental)
1177 GARDEN WALK BLVD
COLLEGE PARK, GA 30349
Fulton County (770) 997-9090

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Paul Ivey Nettles LLC's NPI number?

The NPI number for Paul Ivey Nettles LLC is 1063564078. It was assigned to this organization in the NPPES registry on January 18, 2007.

Where is Paul Ivey Nettles LLC located?

Paul Ivey Nettles LLC is located at 1177 Garden Walk Blvd, College Park, GA 30349. The listed phone number is (770) 997-9090.

What is Paul Ivey Nettles LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Paul Ivey Nettles LLC was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.