Provider Demographics
NPI:1649867011
Name:JOHNS CREEK DENTAL STUDIO PC
Entity type:Organization
Organization Name:JOHNS CREEK DENTAL STUDIO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARJUN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARIKH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-849-6131
Mailing Address - Street 1:270 17TH ST NW UNIT 2409
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30363-1255
Mailing Address - Country:US
Mailing Address - Phone:678-849-6131
Mailing Address - Fax:
Practice Address - Street 1:5455 MCGINNIS VILLAGE PL STE 103
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-1741
Practice Address - Country:US
Practice Address - Phone:770-751-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental