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ITARUT DENTAL LLC
NPI 1164986113
Clinic/Center - Dental in Tucker, GA

Active since January 24, 2019
3756 LA VISTA RD, SUITE 102, TUCKER, GA 30084(404) 636-4700 Get Directions Write a Review

NPPES record last updated: January 24, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Itarut Dental Llc NPPES

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

ITARUT DENTAL LLC (NPI 1164986113), doing business as Northlake Family Dentistry, is a healthcare organization registered as a dental in Tucker, Georgia and active in the NPI registry since January 2019. The organization lists Piyanut Itarut, Organizer, as its authorized official.

NPPES Registry Identity

NPI1164986113
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameITARUT DENTAL LLC
Location Address3756 LA VISTA RD, SUITE 102Tucker, GA 30084-5642
Mailing Address3756 La Vista Rd, Suite 102Tucker, GA 30084-5642 · (404) 636-4700
Phone(404) 636-4700
Organization SubpartNo
Authorized OfficialPiyanut ItarutOrganizer · (618) 977-6071
Enumeration DateJanuary 24, 2019
✔ NPI 1164986113 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
3756 LA VISTA RD, Tucker, GA 30084
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Other Names 1

Doing Business AsNorthlake Family Dentistry

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 Itarut Dental LLC's NPI number?

The NPI number for Itarut Dental LLC is 1164986113. It was assigned to this organization in the NPPES registry on January 24, 2019. The provider is doing business as Northlake Family Dentistry.

Where is Itarut Dental LLC located?

Itarut Dental LLC is located at 3756 La Vista Rd Suite 102, Tucker, GA 30084. The listed phone number is (404) 636-4700.

What is Itarut Dental LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Itarut Dental LLC was last updated on January 24, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.