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FAMILY DENTISTRY OF NORTHLAKE
NPI 1215315312
Dentist - General Practice in Tucker, GA

Active since May 11, 2015
3983 LAVISTA RD STE 104, TUCKER, GA 30084(770) 723-1111 Get Directions Write a Review

NPPES record last updated: May 11, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Family Dentistry Of Northlake NPPES

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

FAMILY DENTISTRY OF NORTHLAKE (NPI 1215315312) is a healthcare organization registered as a general practice in Tucker, Georgia and active in the NPI registry since May 2015. The organization lists Kim Wilson, Cred Sup, as its authorized official.

NPPES Registry Identity

NPI1215315312
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameGEORGIA DENTAL PROFESSIONALS, PC
Location Address3983 LAVISTA RD STE 104Tucker, GA 30084-5140
Mailing Address3983 Lavista Rd Ste 104Tucker, GA 30084-5140 · (770) 723-1111
Phone(770) 723-1111
Organization SubpartYes
Authorized OfficialKim WilsonCred Sup · (217) 540-5170
Enumeration DateMay 11, 2015
✔ NPI 1215315312 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
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.
3983 LAVISTA RD STE 104, Tucker, GA 30084
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Other Names 1

Doing Business AsFamily Dentistry Of Northlake

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

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

DR. RACQUEL LEWIS VAUGHN DMD
Dentist (General Practice)
3983 LAVISTA RD STE 104
TUCKER, GA 30084
Dekalb County (770) 723-1111

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 Georgia Dental Professionals, PC's NPI number?

The NPI number for Georgia Dental Professionals, PC is 1215315312. It was assigned to this organization in the NPPES registry on May 11, 2015. The provider is doing business as Family Dentistry Of Northlake.

Where is Georgia Dental Professionals, PC located?

Georgia Dental Professionals, PC is located at 3983 Lavista Rd Ste 104, Tucker, GA 30084. The listed phone number is (770) 723-1111.

What is Georgia Dental Professionals, PC's specialty?

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

When was this NPI record last updated?

The NPPES record for Georgia Dental Professionals, PC was last updated on May 11, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.