Organization · Type 2 NPI

Children's Dentistry of Lithonia, LLC

Pediatric Dentistry · Lawrenceville, GA

NPI number 1316434095 Active

Practice location

4850 Sugarloaf Parkway, Ste 611
Lawrenceville, GA 30044

Fax (678) 691-9589

Specialties and licenses

Taxonomy	Code	License
Pediatric Dentistry Primary	1223P0221X	DN013400 (GA)

Pediatric Dentistry: 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.

Other pediatric dentistry providers in Lawrenceville

Raymond C. Lyew D.d.s., P.c.Pediatric Dentistry Lawrenceville, GA NPI 1831241744

See all in Lawrenceville →

NPI record

NPI: 1316434095
Entity type: Organization (Type 2)
Issued: Apr 18, 2018
Last updated: Apr 18, 2018
Status: Active
Subpart: Yes of Children's Dentistry of Lithonia, LLC

Other names

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Children's Dentistry of Lawrenceville · doing business as

Authorized official

Mr. Adesegun Olushola Tewogbade, DMD
Pediatric Dentist/owner
(770) 584-5267

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1316434095

Children's Dentistry of Lithonia, LLC's National Provider Identifier is 1316434095, issued on Apr 18, 2018. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Lawrenceville, GA. The record was last updated on Apr 18, 2018.