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LIFE BRIDGE DENTAL GA LLC
NPI 1609532126
Dentist in Atlanta, GA

Active since November 09, 2021
675 PONCE DE LEON AVE NE, ATLANTA, GA 30308(212) 686-3686(615) 468-0325 Get Directions Write a Review

NPPES record last updated: November 9, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Life Bridge Dental Ga Llc NPPES

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

LIFE BRIDGE DENTAL GA LLC (NPI 1609532126) is a healthcare organization registered as a dentist in Atlanta, Georgia and active in the NPI registry since November 2021. The organization lists Kenneth Neil Sullivan, Director Rcm, as its authorized official.

NPPES Registry Identity

NPI1609532126
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameLIFE BRIDGE DENTAL GA LLC
Location Address675 PONCE DE LEON AVE NEAtlanta, GA 30308-1884
Mailing Address8 City Blvd Ste 203Nashville, TN 37209-2559 · (212) 686-3686 · Fax (615) 468-0325
Phone(212) 686-3686
Fax(615) 468-0325
Organization SubpartNo
Authorized OfficialKenneth Neil SullivanDirector Rcm · (615) 601-5250
Enumeration DateNovember 9, 2021
NPPES CertifiedNovember 9, 2021
✔ NPI 1609532126 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
Also ListedDentist · Orthodontics and Dentofacial OrthopedicsTaxonomy 1223X0400X
675 PONCE DE LEON AVE NE, Atlanta, GA 30308
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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 Life Bridge Dental Ga LLC's NPI number?

The NPI number for Life Bridge Dental Ga LLC is 1609532126. It was assigned to this organization in the NPPES registry on November 9, 2021.

Where is Life Bridge Dental Ga LLC located?

Life Bridge Dental Ga LLC is located at 675 Ponce De Leon Ave NE, Atlanta, GA 30308. The listed phone number is (212) 686-3686.

What is Life Bridge Dental Ga LLC's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Life Bridge Dental Ga LLC was last updated on November 9, 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.