Healthcare Provider Details

I. General information

NPI: 1477418176
Provider Name (Legal Business Name): LITTLE PEARLS PEDIATRIC DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 INDIAN TRAIL LILBURN RD STE 300
NORCROSS GA
30093-5553
US

IV. Provider business mailing address

1235 INDIAN TRAIL LILBURN RD STE 300
NORCROSS GA
30093-5553
US

V. Phone/Fax

Practice location:
  • Phone: 770-837-9431
  • Fax: 770-837-9451
Mailing address:
  • Phone: 770-837-9431
  • Fax: 770-837-9451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. AFSHAN BINTORY
Title or Position: PEDIATRIC DENTIST
Credential: DMD
Phone: 770-837-9431