Provider Demographics
NPI:1164411674
Name:DENTISTRY FOR CHILDREN
Entity Type:Organization
Organization Name:DENTISTRY FOR CHILDREN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVITT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:770-478-8400
Mailing Address - Street 1:125 EAGLES POINTE PKWY
Mailing Address - Street 2:SUITE 120
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-6379
Mailing Address - Country:US
Mailing Address - Phone:770-473-1350
Mailing Address - Fax:770-692-0098
Practice Address - Street 1:435 ARROWHEAD BLVD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-1219
Practice Address - Country:US
Practice Address - Phone:770-478-8700
Practice Address - Fax:770-473-8766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty