Provider Demographics
NPI:1427519081
Name:DENTFIRST, P.C.
Entity type:Organization
Organization Name:DENTFIRST, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACTS, CRED & BENEFITS MGR
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:S
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-446-8000
Mailing Address - Street 1:1650 OAKBROOK DR STE 440
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-1817
Mailing Address - Country:US
Mailing Address - Phone:770-446-8000
Mailing Address - Fax:
Practice Address - Street 1:530 17TH ST NW STE 340
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-5037
Practice Address - Country:US
Practice Address - Phone:404-975-1735
Practice Address - Fax:678-701-3305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-27
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty