OrganizationActive
Georgia Dental Professionals, PC
NPI 1104218361 · General Practice Dentistry · Marietta, GA
Georgia Dental Professionals, PC is a General Practice Dentistry organization in Marietta, GA (NPI 1104218361).
Provider details
- NPI number
- 1104218361
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Parent organization
- Georgia Dental Professionals, PC
- Organization subpart
- Yes
- Authorized official
- Kim Wilson, Cred Sup(217) 540-5170
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(74/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3052 Shallowford Rd Ste 100
Marietta, GA 30062-1252
Phone: (770) 587-5655
Street-level locationGet directions
Mailing address
3052 Shallowford Rd Ste 100
Marietta, GA 30062-1252
Other names (DBA / former)
- Doing business as
- Elite Dentistry
Registry dates
- Enumerated
- 2015-02-25
- Last updated
- 2015-02-25
Frequently asked questions
- What is Georgia Dental Professionals, PC's NPI number?
- Georgia Dental Professionals, PC's National Provider Identifier (NPI) is 1104218361, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Georgia Dental Professionals, PC?
- Georgia Dental Professionals, PC is classified in the NPPES registry as General Practice Dentistry (Dental Providers).
- Where is Georgia Dental Professionals, PC located?
- Georgia Dental Professionals, PC's practice location on file with NPPES is 3052 Shallowford Rd Ste 100, Marietta, GA 30062-1252.
- What is Georgia Dental Professionals, PC's phone number?
- The practice phone number listed in the NPPES registry for Georgia Dental Professionals, PC is (770) 587-5655.
- Who is the authorized official for Georgia Dental Professionals, PC?
- The authorized official listed on Georgia Dental Professionals, PC's NPPES record is Kim Wilson, Cred Sup. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Georgia Dental Professionals, PC's NPI active?
- Yes — Georgia Dental Professionals, PC's NPI (1104218361) is active in the NPPES registry as of the last update on 2015-02-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.