PROFESSIONAL DENTAL ALLIANCE OF LILBURN, LLC
NPI 1710544960
Dentist - General Practice in Lilburn, GA

Q: What is Professional Dental Alliance Of Lilburn, LLC's specialty?

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

Active since May 23, 2019

3970 FIVE FORKS TRICKUM RD SW STE B, LILBURN, GA 30047(770) 921-8442 Get Directions Write a Review

NPPES record last updated: May 23, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Professional Dental Alliance Of Lilburn, Llc NPPES

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

PROFESSIONAL DENTAL ALLIANCE OF LILBURN, LLC (NPI 1710544960) is a healthcare organization registered as a general practice in Lilburn, Georgia and active in the NPI registry since May 2019. The organization lists Jessica Barrette, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1710544960

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NamePROFESSIONAL DENTAL ALLIANCE OF LILBURN, LLC

Location Address3970 FIVE FORKS TRICKUM RD SW STE BLilburn, GA 30047-2339

Mailing Address11 S Mill St Ste 200New Castle, PA 16101-3680

Phone(770) 921-8442

Organization SubpartNo

Authorized OfficialJessica BarretteCredentialing Specialist · (724) 698-2997

Enumeration DateMay 23, 2019

✔ NPI 1710544960 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.

3970 FIVE FORKS TRICKUM RD SW STE B, Lilburn, GA 30047

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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 Professional Dental Alliance Of Lilburn, LLC's NPI number?

The NPI number for Professional Dental Alliance Of Lilburn, LLC is 1710544960. It was assigned to this organization in the NPPES registry on May 23, 2019.

Where is Professional Dental Alliance Of Lilburn, LLC located?

Professional Dental Alliance Of Lilburn, LLC is located at 3970 Five Forks Trickum Rd SW Ste B, Lilburn, GA 30047. The listed phone number is (770) 921-8442.

What is Professional Dental Alliance Of Lilburn, LLC'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 Professional Dental Alliance Of Lilburn, LLC was last updated on May 23, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.