Platinum Dental Group Gainesville, Llc
LBN: Platinum Dental Group Gainesville, Llc
Platinum Dental Group Gainesville, Llc is an health care organization with primary practice located at 3535 Thompson Bridge Rd , Gainesville GA 30506. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is the primary health care specialty.
Platinum Dental Group Gainesville, Llc can be contacted via phone (770) 534-5374, or through Thebaut, Mark Denny via phone (678) 990-6301.
Contact Information
Primary practice address
3535 Thompson Bridge Rd
Gainesville GA 30506
Phone: (770) 534-5374
Fax: (770) 534-5591
Website:
Authorized official contact:
Name: Thebaut, Mark Denny Doctor of Dental Surgery (DDS)
Phone: (678) 990-6301
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | ||
| Dental Providers / Pediatric Dentistry | 1223P0221X |
Profile Details
| NPI number | 1083948491 |
|---|---|
| LBN Legal business name | Platinum Dental Group Gainesville, Llc |
| DBA Doing business as | |
| Authorized official | Thebaut, Mark Denny Doctor of Dental Surgery (DDS) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 1st, 2009 |
| Last updated | Oct 1st, 2009 - about 16 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083948491 | NPPES |
| Georgia | MEDICAID | 000185875H | |
| Georgia | MEDICAID | 232076497C | |
| Georgia | MEDICAID | 149199935C | |
| Georgia | MEDICAID | 177273740C | |
| Georgia | MEDICAID | 151700972D | |
| Georgia | MEDICAID | 591447276D |
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