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FAYETTEVILLE PEDIATRIC DENTISTRY
NPI 1073056933
Dentist - Pediatric Dentistry in Fayetteville, GA

Active since November 28, 2016
320 N JEFF DAVIS DR, SUITE C, FAYETTEVILLE, GA 30214(770) 651-1000 Get Directions Write a Review

NPPES record last updated: November 28, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Fayetteville Pediatric Dentistry NPPES

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

FAYETTEVILLE PEDIATRIC DENTISTRY (NPI 1073056933) is a healthcare organization registered as a pediatric dentistry in Fayetteville, Georgia and active in the NPI registry since November 2016. The organization lists Vishant Nath, Dentist, as its authorized official.

NPPES Registry Identity

NPI1073056933
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameFAYETTEVILLE PEDIATRIC DENTISTRY
Location Address320 N JEFF DAVIS DR, SUITE CFayetteville, GA 30214-1669
Mailing Address320 N Jeff Davis Dr, Suite CFayetteville, GA 30214-1669 · (770) 651-1000
Phone(770) 651-1000
Organization SubpartNo
Authorized OfficialVishant NathDentist · (770) 651-1000
Enumeration DateNovember 28, 2016
✔ NPI 1073056933 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in GA · DN013057
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.
320 N JEFF DAVIS DR, Fayetteville, GA 30214
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

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

DR. ARTIE RICAUD DDS CDT
Dentist
320 N JEFF DAVIS DR, SUITE B
FAYETTEVILLE, GA 30214
Fayette County (770) 461-3921
MICHAEL E WILSON OD PC
Optometrist
320 N JEFF DAVIS DR, SUITE A
FAYETTEVILLE, GA 30214
Fayette County (770) 461-2144
FAYETTEVILLE ORTHODONTICS LLC
Dentist (Orthodontics and Dentofacial Orthopedics)
320 N JEFF DAVIS DR, SUITE C
FAYETTEVILLE, GA 30214
Fayette County (770) 460-6000

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 Fayetteville Pediatric Dentistry's NPI number?

The NPI number for Fayetteville Pediatric Dentistry is 1073056933. It was assigned to this organization in the NPPES registry on November 28, 2016.

Where is Fayetteville Pediatric Dentistry located?

Fayetteville Pediatric Dentistry is located at 320 N Jeff Davis Dr Suite C, Fayetteville, GA 30214. The listed phone number is (770) 651-1000.

What is Fayetteville Pediatric Dentistry'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 Fayetteville Pediatric Dentistry was last updated on November 28, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.