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PLATINUM DENTAL GROUP GAINESVILLE, LLC
NPI 1083948491
Dentist - Pediatric Dentistry in Gainesville, GA

Active since October 01, 2009
3535 THOMPSON BRIDGE RD, GAINESVILLE, GA 30506(770) 534-5374(770) 534-5591 Get Directions Write a Review

NPPES record last updated: October 1, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Platinum Dental Group Gainesville, Llc NPPES

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

PLATINUM DENTAL GROUP GAINESVILLE, LLC (NPI 1083948491) is a healthcare organization registered as a pediatric dentistry in Gainesville, Georgia and active in the NPI registry since October 2009. The organization lists Mark Denny Thebaut, Owner/dentist, as its authorized official.

NPPES Registry Identity

NPI1083948491
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NamePLATINUM DENTAL GROUP GAINESVILLE, LLC
Location Address3535 THOMPSON BRIDGE RDGainesville, GA 30506
Mailing Address3535 Thompson Bridge RdGainesville, GA 30506 · (770) 534-5374 · Fax (770) 534-5591
Phone(770) 534-5374
Fax(770) 534-5591
Organization SubpartNo
Authorized OfficialMark Denny ThebautOwner/dentist · (678) 990-6301
Enumeration DateOctober 1, 2009
✔ NPI 1083948491 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
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
3535 THOMPSON BRIDGE RD, Gainesville, GA 30506
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Other Identifiers 6

Medicaid151700972DGA
Medicaid000185875HGA
Medicaid177273740CGA
Medicaid232076497CGA
Medicaid149199935CGA
Medicaid591447276DGA

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 2

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

DR. STANLEY SOTNIKOV DDS
Dentist (General Practice)
3535 THOMPSON BRIDGE RD
GAINESVILLE, GA 30506
Hall County (770) 534-5374
PLATINUM DENTAL OF GAINESVILLE
Dentist (Pediatric Dentistry)
3535 THOMPSON BRIDGE RD
GAINESVILLE, GA 30506
Hall County (770) 534-5374

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 Platinum Dental Group Gainesville, LLC's NPI number?

The NPI number for Platinum Dental Group Gainesville, LLC is 1083948491. It was assigned to this organization in the NPPES registry on October 1, 2009.

Where is Platinum Dental Group Gainesville, LLC located?

Platinum Dental Group Gainesville, LLC is located at 3535 Thompson Bridge Rd, Gainesville, GA 30506. The listed phone number is (770) 534-5374.

What is Platinum Dental Group Gainesville, 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 Platinum Dental Group Gainesville, LLC was last updated on October 1, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.