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GWINNETT CHILDRENS DENTISTRY
NPI 1447377130
Dentist - Pediatric Dentistry in Lilburn, GA

Active since March 26, 2007
609 BEAVER RUIN RD NW, SUITE A, LILBURN, GA 30047(770) 925-3301(770) 709-0001 Get Directions Write a Review

NPPES record last updated: June 18, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Gwinnett Childrens Dentistry NPPES

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

GWINNETT CHILDRENS DENTISTRY (NPI 1447377130) is a healthcare organization registered as a pediatric dentistry 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

NPI1447377130
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameMARK D THEBAUT DDS PC
Location Address609 BEAVER RUIN RD NW, SUITE ALilburn, GA 30047-3401
Mailing Address609 Beaver Ruin Rd Nw, Suite ALilburn, GA 30047-3401 · (770) 925-3300 · Fax (770) 925-3302
Phone(770) 925-3301
Fax(770) 709-0001
Organization SubpartNo
Authorized OfficialMark D ThebautOwner · (770) 925-3301
Enumeration DateMarch 26, 2007
Last NPPES UpdateJune 18, 2008
✔ NPI 1447377130 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 · 9113
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.
609 BEAVER RUIN RD NW, Lilburn, GA 30047
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Other Names 1

Doing Business AsGwinnett Childrens Dentistry

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

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 4

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

DR. MARK D THEBAUT DDS
Dentist (Pediatric Dentistry)
609 BEAVER RUIN RD NW
LILBURN, GA 30047
Gwinnett County (770) 925-3300
DR. MARK INMAN COHEN D.D.S.
Dentist (Periodontics)
609 BEAVER RUIN RD NW, SUITE E
LILBURN, GA 30047
Gwinnett County (770) 717-5552
DR. BELEMA ABERE DMD
Dentist (Pediatric Dentistry)
609 BEAVER RUIN RD NW
LILBURN, GA 30047
Gwinnett County (305) 637-6400
DR. GREGORY A CLEPPER DMD
Dentist (General Practice)
609 BEAVER RUIN RD NW
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 Mark D Thebaut Dds PC's NPI number?

The NPI number for Mark D Thebaut Dds PC is 1447377130. It was assigned to this organization in the NPPES registry on March 26, 2007. The provider is doing business as Gwinnett Childrens Dentistry.

Where is Mark D Thebaut Dds PC located?

Mark D Thebaut Dds PC is located at 609 Beaver Ruin Rd NW Suite A, Lilburn, GA 30047. The listed phone number is (770) 925-3301.

What is Mark D Thebaut Dds PC's specialty?

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

What insurance does Mark D Thebaut Dds PC accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Mark D Thebaut Dds PC 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 Mark D Thebaut Dds PC was last updated on June 18, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.