SMILE SOURCE ATLANTA EAST
NPI 1518622869
Dentist - General Practice in Stone Mountain, GA

Q: What is Smile Source Atlanta East's NPI number?

The NPI number for Smile Source Atlanta East is 1518622869. It was assigned to this organization in the NPPES registry on November 2, 2021.

Q: What is Smile Source Atlanta East's specialty?

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

Active since November 02, 2021

1147 S HAIRSTON RD STE A, STONE MOUNTAIN, GA 30088(678) 515-4200(678) 515-4201 Get Directions Write a Review

NPPES record last updated: November 2, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Smile Source Atlanta East NPPES

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

SMILE SOURCE ATLANTA EAST (NPI 1518622869) is a healthcare organization registered as a general practice in Stone Mountain, Georgia and active in the NPI registry since November 2021. The organization lists Keonka M Williams, Business Manager, as its authorized official.

NPPES Registry Identity

NPI1518622869

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameSMILE SOURCE ATLANTA EAST

Location Address1147 S HAIRSTON RD STE AStone Mountain, GA 30088-2757

Mailing Address1100 Peachtree St Ne Ste 680Atlanta, GA 30309-4516 · (404) 897-1699 · Fax (404) 897-1599

Phone(678) 515-4200

Fax(678) 515-4201

Organization SubpartNo

Authorized OfficialKeonka M WilliamsBusiness Manager · (404) 897-1699

Enumeration DateNovember 2, 2021

NPPES CertifiedNovember 2, 2021

✔ NPI 1518622869 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.

1147 S HAIRSTON RD STE A, Stone Mountain, GA 30088

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Other Identifiers 2

OtherDN122249GA · Ga Board Of Dentitstry

OtherDN011069GA · Ga Board Of Dentistry

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

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 Smile Source Atlanta East's NPI number?

The NPI number for Smile Source Atlanta East is 1518622869. It was assigned to this organization in the NPPES registry on November 2, 2021.

Where is Smile Source Atlanta East located?

Smile Source Atlanta East is located at 1147 S Hairston Rd Ste A, Stone Mountain, GA 30088. The listed phone number is (678) 515-4200.

What is Smile Source Atlanta East'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 Smile Source Atlanta East was last updated on November 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.