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NPI Code Detail

MEDICARE: CHILDREN'S DENTISTRY OF CHASTAIN LLC

MEDICARE: CHILDREN'S DENTISTRY OF CHASTAIN LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0221XPediatric Dentistry

General Provider Information

NPI Number : 1164371233
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHILDREN'S DENTISTRY OF CHASTAIN LLC
Provider Business Mailing Address
First Line : 91 W WIEUCA RD NE STE 400
Second Line :
City : ATLANTA
State : GA
Zip : 30342-3248
Country : US
Telephone Number : 770-971-5536
Fax Number : 770-971-3046
Provider Business Practice Location Address
First Line : 91 W WIEUCA RD NE STE 400
Second Line :
City : ATLANTA
State : GA
Zip : 30342-3248
Country : US
Telephone Number : 770-971-5536
Fax Number : 770-971-3046
Authorized Official
Title or Position : DDS
Name : MR. TODD ASARCH
Credential : DDS
Telephone Number : 770-971-5536
Provider Enumeration Date : 01/22/2026
Last Update Date : 01/22/2026

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Directions to “CHILDREN'S DENTISTRY OF CHASTAIN LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.