1. Home
  2. Directory
  3. Georgia
  4. Newnan
  5. Clinic Center
  6. NPI Profile

PROVIDENCE DENTAL SPA OF NEWNAN, LLC
NPI 1679231831
Clinic/Center - Dental in Newnan, GA

Active since December 06, 2021
166 JEFFERSON PKWY, NEWNAN, GA 30263(770) 252-1300(770) 252-1763 Get Directions Write a Review

NPPES record last updated: December 6, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Providence Dental Spa Of Newnan, Llc NPPES

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

PROVIDENCE DENTAL SPA OF NEWNAN, LLC (NPI 1679231831) is a healthcare organization registered as a dental in Newnan, Georgia and active in the NPI registry since December 2021. The organization lists Paul Jason Mann, Managing Partner, as its authorized official.

NPPES Registry Identity

NPI1679231831
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NamePROVIDENCE DENTAL SPA OF NEWNAN, LLC
Location Address166 JEFFERSON PKWYNewnan, GA 30263-5822
Mailing Address225 N Macon StMacon, GA 31210-6562 · (478) 733-0857 · Fax (478) 254-5709
Phone(770) 252-1300
Fax(770) 252-1763
Organization SubpartNo
Authorized OfficialPaul Jason MannManaging Partner · (770) 550-7741
Enumeration DateDecember 6, 2021
NPPES CertifiedDecember 6, 2021
✔ NPI 1679231831 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
166 JEFFERSON PKWY, Newnan, GA 30263
Open in Google Maps ↗

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 Providence Dental Spa Of Newnan, LLC's NPI number?

The NPI number for Providence Dental Spa Of Newnan, LLC is 1679231831. It was assigned to this organization in the NPPES registry on December 6, 2021.

Where is Providence Dental Spa Of Newnan, LLC located?

Providence Dental Spa Of Newnan, LLC is located at 166 Jefferson Pkwy, Newnan, GA 30263. The listed phone number is (770) 252-1300.

What is Providence Dental Spa Of Newnan, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Providence Dental Spa Of Newnan, LLC was last updated on December 6, 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.