Healthcare Provider Details

I. General information

NPI: 1013834530
Provider Name (Legal Business Name): PINO DENTAL STUDIO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 THE EXCHANGE SE STE 600
ATLANTA GA
30339-2083
US

IV. Provider business mailing address

1820 THE EXCHANGE SE STE 600
ATLANTA GA
30339-2083
US

V. Phone/Fax

Practice location:
  • Phone: 770-953-1752
  • Fax: 770-953-6470
Mailing address:
  • Phone: 770-953-1752
  • Fax: 770-953-6470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. OSCAR PINO
Title or Position: OWNER
Credential: DDS
Phone: 714-325-9936