CENTER FOR PEDIATRIC DENTISTRY, LLC
NPI 1164490918
Dentist - Pediatric Dentistry in Augusta, GA

Q: What is Center For Pediatric Dentistry, LLC's NPI number?

The NPI number for Center For Pediatric Dentistry, LLC is 1164490918. It was assigned to this organization in the NPPES registry on March 9, 2006. The provider was formerly known as Center For Pediatric Dentistry, PC.

Q: What is Center For Pediatric Dentistry, LLC's specialty?

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

Active since March 09, 2006

1243 AUGUSTA WEST PKWY, AUGUSTA, GA 30909(706) 855-8989(706) 855-0321 Get Directions Write a Review

NPPES record last updated: January 18, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Center For Pediatric Dentistry, Llc NPPES

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

CENTER FOR PEDIATRIC DENTISTRY, LLC (NPI 1164490918), doing business as Center For Pediatric Dentistry, Pc, is a healthcare organization registered as a pediatric dentistry in Augusta, Georgia and active in the NPI registry since March 2006. The organization lists Mary Shirley, Administrator, as its authorized official.

NPPES Registry Identity

NPI1164490918

Entity TypeOrganization

Primary Taxonomy1223P0221X

Legal Business NameCENTER FOR PEDIATRIC DENTISTRY, LLC

Location Address1243 AUGUSTA WEST PKWYAugusta, GA 30909-1807

Mailing Address1243 Augusta West PkwyAugusta, GA 30909-1807 · (706) 855-8989 · Fax (706) 855-0321

Phone(706) 855-8989

Fax(706) 855-0321

Organization SubpartNo

Authorized OfficialMary ShirleyAdministrator · (706) 855-8989

Enumeration DateMarch 9, 2006

Last NPPES UpdateJanuary 18, 2021

NPPES CertifiedJanuary 18, 2021

✔ NPI 1164490918 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 · 11680

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.

1243 AUGUSTA WEST PKWY, Augusta, GA 30909

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Other Names 1

Former Legal Business NameCenter For Pediatric Dentistry, Pc

Other Identifiers 1

Medicaid945328611AGA

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 6

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

DR. KELLY WALLACE HUGHES DMD

Dentist (Pediatric Dentistry)