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STATESBORO PEDIATRIC DENTISTRY, LLC
NPI 1568935286
Dentist - Pediatric Dentistry in Statesboro, GA

Active since January 04, 2019
613 E GRADY ST, STATESBORO, GA 30458(478) 456-5907 Get Directions Write a Review

NPPES record last updated: January 4, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Statesboro Pediatric Dentistry, Llc NPPES

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

STATESBORO PEDIATRIC DENTISTRY, LLC (NPI 1568935286) is a healthcare organization registered as a pediatric dentistry in Statesboro, Georgia and active in the NPI registry since January 2019. The organization lists Anjali Puri Patel, Dentist/owner, as its authorized official.

NPPES Registry Identity

NPI1568935286
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameSTATESBORO PEDIATRIC DENTISTRY, LLC
Location Address613 E GRADY STStatesboro, GA 30458-5104
Mailing Address101 Irongate PlStatesboro, GA 30458-9195 · (478) 456-5907
Phone(478) 456-5907
Organization SubpartNo
Authorized OfficialAnjali Puri PatelDentist/owner · (478) 456-5907
Enumeration DateJanuary 4, 2019
✔ NPI 1568935286 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
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.

613 E GRADY ST, Statesboro, GA 30458
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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 3

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

DR. ANJALI PURI PATEL DMD
Dentist
613 E GRADY ST
STATESBORO, GA 30458
Bulloch County (912) 259-9543
EAST GEORGIA ORAL & MAXILLOFACIAL SURGERY CENTER
Clinic/Center (Dental)
613 E GRADY ST
STATESBORO, GA 30458
Bulloch County (912) 764-5435
DR. RODRIGO LORENZO URIBE D.M.D.
Dentist (Oral and Maxillofacial Surgery)
613 E GRADY ST
STATESBORO, GA 30458
Bulloch County (912) 764-5435

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 Statesboro Pediatric Dentistry, LLC's NPI number?

The NPI number for Statesboro Pediatric Dentistry, LLC is 1568935286. It was assigned to this organization in the NPPES registry on January 4, 2019.

Where is Statesboro Pediatric Dentistry, LLC located?

Statesboro Pediatric Dentistry, LLC is located at 613 E Grady St, Statesboro, GA 30458. The listed phone number is (478) 456-5907.

What is Statesboro Pediatric Dentistry, LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Statesboro Pediatric Dentistry, LLC was last updated on January 4, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.