Children and Teen Dental Group
NPI 1255139432ActiveOrganization· Dentist, General Practice· Cornelia, GA
Dentist, General Practice in Cornelia, Georgia, registered in NPPES in March 2025, part of Children and Teen Dental Group. The authorized official on file is Brian Smith, President.
Overview
| NPI | 1255139432 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Children and Teen Dental Group |
| NPI issued | Mar 4, 2025 |
| Last updated in NPPES | Jul 7, 2026 |
| Certified by provider | Jul 7, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | — | — |
| Dentist, Pediatric Dentistry | 1223P0221X | — | — |
| Dentist, Oral and Maxillofacial Surgery | 1223S0112X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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