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PROFESSIONAL DENTAL ALLIANCE OF CONYERS, LLC
NPI 1811554058
Dentist - General Practice in Conyers, GA

Active since May 23, 2019
1820 GEORGIA HIGHWAY 20 SE STE 148, CONYERS, GA 30013(770) 922-4375 Get Directions Write a Review

NPPES record last updated: May 23, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Professional Dental Alliance Of Conyers, Llc NPPES

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

PROFESSIONAL DENTAL ALLIANCE OF CONYERS, LLC (NPI 1811554058) is a healthcare organization registered as a general practice in Conyers, Georgia and active in the NPI registry since May 2019. The organization lists Jessica Barrette, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1811554058
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NamePROFESSIONAL DENTAL ALLIANCE OF CONYERS, LLC
Location Address1820 GEORGIA HIGHWAY 20 SE STE 148Conyers, GA 30013-2076
Mailing Address11 S Mill St Ste 200New Castle, PA 16101-3680
Phone(770) 922-4375
Organization SubpartNo
Authorized OfficialJessica BarretteCredentialing Specialist · (724) 698-2997
Enumeration DateMay 23, 2019
✔ NPI 1811554058 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.
1820 GEORGIA HIGHWAY 20 SE STE 148, Conyers, GA 30013
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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 Conyers, LLC's NPI number?

The NPI number for Professional Dental Alliance Of Conyers, LLC is 1811554058. It was assigned to this organization in the NPPES registry on May 23, 2019.

Where is Professional Dental Alliance Of Conyers, LLC located?

Professional Dental Alliance Of Conyers, LLC is located at 1820 Georgia Highway 20 SE Ste 148, Conyers, GA 30013. The listed phone number is (770) 922-4375.

What is Professional Dental Alliance Of Conyers, 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 Conyers, 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.