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PLATINUM DENTAL OF LILBURN
NPI 1154448850
Dentist - General Practice in Lilburn, GA

Active since March 26, 2007
609 BEAVER RUIN RD NW STE A, LILBURN, GA 30047(770) 709-0000(770) 925-3302 Get Directions Write a Review

NPPES record last updated: March 25, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Platinum Dental Of Lilburn NPPES

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

PLATINUM DENTAL OF LILBURN (NPI 1154448850), doing business as Platinum Dental Lilburn, Llc, is a healthcare organization registered as a general practice in Lilburn, Georgia and active in the NPI registry since March 2007. The organization lists Mark D Thebaut, Owner, as its authorized official.

NPPES Registry Identity

NPI1154448850
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NamePLATINUM DENTAL OF LILBURN
Location Address609 BEAVER RUIN RD NW STE ALilburn, GA 30047-3401
Mailing Address609 Beaver Ruin Rd Nw Ste ALilburn, GA 30047-3401 · (770) 709-0000 · Fax (770) 925-3302
Phone(770) 709-0000
Fax(770) 925-3302
Organization SubpartNo
Authorized OfficialMark D ThebautOwner · (770) 709-0000
Enumeration DateMarch 26, 2007
Last NPPES UpdateMarch 25, 2009
✔ NPI 1154448850 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in GA · 9113
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
609 BEAVER RUIN RD NW STE A, Lilburn, GA 30047
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Other Names 1

Former Legal Business NamePlatinum Dental Lilburn, Llc

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

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.

ALEIDA FROMETA-PREVAL D.A.
Dental Assistant
609 BEAVER RUIN RD NW STE A
LILBURN, GA 30047
Gwinnett County (770) 925-3300
MAXINE HANDSOR D.A.
Dental Assistant
609 BEAVER RUIN RD NW STE A
LILBURN, GA 30047
Gwinnett County (770) 925-3300
MISS CHRISTINA M WATTS D.A.
Dental Assistant
609 BEAVER RUIN RD NW STE A
LILBURN, GA 30047
Gwinnett County (770) 925-3300
JINA LEE
Dentist (General Practice)
609 BEAVER RUIN RD NW STE A
LILBURN, GA 30047
Gwinnett County (770) 925-3300
DAWN M ROSALES
Dental Assistant
609 BEAVER RUIN RD NW STE A
LILBURN, GA 30047
Gwinnett County (770) 925-3300

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 Of Lilburn's NPI number?

The NPI number for Platinum Dental Of Lilburn is 1154448850. It was assigned to this organization in the NPPES registry on March 26, 2007. The provider was formerly known as Platinum Dental Lilburn, LLC.

Where is Platinum Dental Of Lilburn located?

Platinum Dental Of Lilburn is located at 609 Beaver Ruin Rd NW Ste A, Lilburn, GA 30047. The listed phone number is (770) 709-0000.

What is Platinum Dental Of Lilburn's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Platinum Dental Of Lilburn accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Platinum Dental Of Lilburn as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Platinum Dental Of Lilburn was last updated on March 25, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.