1. Home
  2. Directory
  3. Georgia
  4. Dacula
  5. Dentist
  6. NPI Profile

TEBO DENTISTRY FOR KIDS DACULA, LLC
NPI 1689938862
Dentist - Pediatric Dentistry in Dacula, GA

Active since July 02, 2012
1152 AUBURN RD, BUILDING 1, SUITE 101, DACULA, GA 30019(770) 925-3300 Get Directions Write a Review

NPPES record last updated: July 2, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Tebo Dentistry For Kids Dacula, Llc NPPES

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

TEBO DENTISTRY FOR KIDS DACULA, LLC (NPI 1689938862) is a healthcare organization registered as a pediatric dentistry in Dacula, Georgia and active in the NPI registry since July 2012. The organization lists Jenniffer Connor, Administrative Assistant, as its authorized official.

NPPES Registry Identity

NPI1689938862
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameTEBO DENTISTRY FOR KIDS DACULA, LLC
Location Address1152 AUBURN RD, BUILDING 1, SUITE 101Dacula, GA 30019-5444
Mailing AddressPo Box 1953Lilburn, GA 30048-1953 · (770) 925-3300
Phone(770) 925-3300
Organization SubpartNo
Authorized OfficialJenniffer ConnorAdministrative Assistant · (678) 990-6331
Enumeration DateJuly 2, 2012
✔ NPI 1689938862 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in GA · DN009113
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.
Also ListedDentist · General PracticeTaxonomy 1223G0001X · License DN009113, DN013919 (GA), DN013997 (GA), DN011863 (GA)
1152 AUBURN RD, Dacula, GA 30019
Open in Google Maps ↗

Other Identifiers 4

Other1730316597GA · Npi
Other1033449517GA · Npi
Other124533238Npi
Other1245432004GA · Npi

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 Tebo Dentistry For Kids Dacula, LLC's NPI number?

The NPI number for Tebo Dentistry For Kids Dacula, LLC is 1689938862. It was assigned to this organization in the NPPES registry on July 2, 2012.

Where is Tebo Dentistry For Kids Dacula, LLC located?

Tebo Dentistry For Kids Dacula, LLC is located at 1152 Auburn Rd Building 1, Suite 101, Dacula, GA 30019. The listed phone number is (770) 925-3300.

What is Tebo Dentistry For Kids Dacula, 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 Tebo Dentistry For Kids Dacula, LLC was last updated on July 2, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.