OrganizationActive
Platinum Dental of Lilburn
NPI 1154448850 · General Practice Dentistry · Lilburn, GA
Platinum Dental of Lilburn is a General Practice Dentistry organization in Lilburn, GA (NPI 1154448850).
Provider details
- NPI number
- 1154448850
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Mark Thebaut, Owner(770) 709-0000
- License
- 9113 (GA)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
609 Beaver Ruin Rd Nw Ste a
Lilburn, GA 30047-3401
Phone: (770) 709-0000
Fax: (770) 925-3302
Street-level locationGet directions
Mailing address
609 Beaver Ruin Rd Nw Ste a
Lilburn, GA 30047-3401
Other names (DBA / former)
- Former legal business name
- Platinum Dental Lilburn, LLC
Registry dates
- Enumerated
- 2007-03-26
- Last updated
- 2009-03-25
Frequently asked questions
- What is Platinum Dental of Lilburn's NPI number?
- Platinum Dental of Lilburn's National Provider Identifier (NPI) is 1154448850, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Platinum Dental of Lilburn?
- Platinum Dental of Lilburn is classified in the NPPES registry as General Practice Dentistry (Dental Providers).
- Where is Platinum Dental of Lilburn located?
- Platinum Dental of Lilburn's practice location on file with NPPES is 609 Beaver Ruin Rd Nw Ste a, Lilburn, GA 30047-3401.
- What is Platinum Dental of Lilburn's phone number?
- The practice phone number listed in the NPPES registry for Platinum Dental of Lilburn is (770) 709-0000.
- Who is the authorized official for Platinum Dental of Lilburn?
- The authorized official listed on Platinum Dental of Lilburn's NPPES record is Mark Thebaut, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Platinum Dental of Lilburn's NPI active?
- Yes — Platinum Dental of Lilburn's NPI (1154448850) is active in the NPPES registry as of the last update on 2009-03-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.