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LEGACY PEDO LLC
NPI 1871813295
Dentist - Pediatric Dentistry in Kennesaw, GA

Active since June 08, 2010
3903 JILES RD NW, #210, KENNESAW, GA 30144(770) 590-9050 Get Directions Write a Review

NPPES record last updated: June 8, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Legacy Pedo Llc NPPES

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

LEGACY PEDO LLC (NPI 1871813295) is a healthcare organization registered as a pediatric dentistry in Kennesaw, Georgia and active in the NPI registry since June 2010. The organization lists Michael Reznik, Owner, as its authorized official.

NPPES Registry Identity

NPI1871813295
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameLEGACY PEDO LLC
Location Address3903 JILES RD NW, #210Kennesaw, GA 30144-4612
Mailing Address3903 Jiles Rd Nw, #210Kennesaw, GA 30144-4612 · (770) 590-9050
Phone(770) 590-9050
Organization SubpartNo
Authorized OfficialMichael ReznikOwner · (770) 777-7427
Enumeration DateJune 8, 2010
✔ NPI 1871813295 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
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.
3903 JILES RD NW, Kennesaw, GA 30144
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ENVISION CHIROPRACTIC
Chiropractor
3903 JILES RD NW, BUILDING 100 SUITE 101
KENNESAW, GA 30144
Cobb County (678) 276-9609
IMAGIX LEGACY PEDIATRICS LLC
Dentist
3903 JILES RD NW, 210
KENNESAW, GA 30144
Cobb County (770) 590-9050
LEGACY ORTHODONTICS II, LLC
Dentist (Orthodontics and Dentofacial Orthopedics)
3903 JILES RD NW, #210
KENNESAW, GA 30144
Cobb County (770) 590-9050

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 Legacy Pedo LLC's NPI number?

The NPI number for Legacy Pedo LLC is 1871813295. It was assigned to this organization in the NPPES registry on June 8, 2010.

Where is Legacy Pedo LLC located?

Legacy Pedo LLC is located at 3903 Jiles Rd NW #210, Kennesaw, GA 30144. The listed phone number is (770) 590-9050.

What is Legacy Pedo 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 Legacy Pedo LLC was last updated on June 8, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.