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PLATINUM DENTAL GROUP SURGICAL CENTER
NPI 1891813408
Dentist - Pediatric Dentistry in Roswell, GA

Active since March 26, 2007
1345 HEMBREE RD, ROSWELL, GA 30076(770) 751-3115(678) 990-1065 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Platinum Dental Group Surgical Center NPPES

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

PLATINUM DENTAL GROUP SURGICAL CENTER (NPI 1891813408), doing business as Platinum Dental Group Surgical Center, Llc, is a healthcare organization registered as a pediatric dentistry in Roswell, Georgia and active in the NPI registry since March 2007. The organization lists Mark D Thebaut, Owner, as its authorized official.

NPPES Registry Identity

NPI1891813408
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NamePLATINUM DENTAL GROUP SURGICAL CENTER
Location Address1345 HEMBREE RDRoswell, GA 30076-3816
Mailing Address1345 Hembree RdRoswell, GA 30076-3816 · (770) 751-3115 · Fax (678) 990-1065
Phone(770) 751-3115
Fax(678) 990-1065
Organization SubpartNo
Authorized OfficialMark D ThebautOwner · (770) 751-3115
Enumeration DateMarch 26, 2007
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
✔ NPI 1891813408 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 · 9113
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 9113 (GA)

Other Names 1

Former Legal Business NamePlatinum Dental Group Surgical Center, Llc

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

Other Providers at the Same Location NPPES 7

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

ARUN NAYYAR DDS
Dentist (Prosthodontics)
1345 HEMBREE RD
ROSWELL, GA 30076
Fulton County (770) 777-7427
PLATINUM DENTAL OF ROSWELL
Dentist (General Practice)
1345 HEMBREE RD
ROSWELL, GA 30076
Fulton County (770) 751-3115
IMAGIX DENTAL MANAGEMENT GROUP IV LLC
Dentist (General Practice)
1345 HEMBREE RD
ROSWELL, GA 30076
Fulton County (770) 777-7427
DR. EUGENE WITKIN DDS
Dentist
1345 HEMBREE RD
ROSWELL, GA 30076
Fulton County (770) 777-7427
IMAGIX DENTAL OF ROSWELL LLC
Dentist
1345 HEMBREE RD
ROSWELL, GA 30076
Fulton County (770) 777-7424
BRITNEY LEWIS
Dentist (General Practice)
1345 HEMBREE RD
ROSWELL, GA 30076
Fulton County (678) 274-6989
CANDICE HARDWICK DDS
Dentist (General Practice)
1345 HEMBREE RD
ROSWELL, GA 30076
Fulton County (678) 274-6989

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 Platinum Dental Group Surgical Center's NPI number?

The NPI number for Platinum Dental Group Surgical Center is 1891813408. It was assigned to this organization in the NPPES registry on March 26, 2007. The provider was formerly known as Platinum Dental Group Surgical Center, LLC.

Where is Platinum Dental Group Surgical Center located?

Platinum Dental Group Surgical Center is located at 1345 Hembree Rd, Roswell, GA 30076. The listed phone number is (770) 751-3115.

What is Platinum Dental Group Surgical Center'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 Platinum Dental Group Surgical Center was last updated on September 11, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.