OrganizationActive
Ccsd-Pc, LLC
NPI 1619820214 · Dental Clinic/Center · Peachtree Corners, GA
Ccsd-Pc, LLC is a Dental Clinic/Center organization in Peachtree Corners, GA (NPI 1619820214).
Provider details
- NPI number
- 1619820214
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Donna Tidwell, Insurance Manager(770) 995-1957
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(53/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in 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
5075 Peachtree Pkwy Ste 105b
Peachtree Corners, GA 30092-6506
Phone: (678) 288-4888
Street-level locationGet directions
Mailing address
5075 Peachtree Pkwy Ste 105b
Peachtree Corners, GA 30092-6506
Registry dates
- Enumerated
- 2026-02-16
- Last updated
- 2026-02-16
- Certified
- 2026-02-16
Frequently asked questions
- What is Ccsd-Pc, LLC's NPI number?
- Ccsd-Pc, LLC's National Provider Identifier (NPI) is 1619820214, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Ccsd-Pc, LLC?
- Ccsd-Pc, LLC is classified in the NPPES registry as Dental Clinic/Center (Ambulatory Health Care Facilities).
- Where is Ccsd-Pc, LLC located?
- Ccsd-Pc, LLC's practice location on file with NPPES is 5075 Peachtree Pkwy Ste 105b, Peachtree Corners, GA 30092-6506.
- What is Ccsd-Pc, LLC's phone number?
- The practice phone number listed in the NPPES registry for Ccsd-Pc, LLC is (678) 288-4888.
- Who is the authorized official for Ccsd-Pc, LLC?
- The authorized official listed on Ccsd-Pc, LLC's NPPES record is Donna Tidwell, Insurance Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Ccsd-Pc, LLC's NPI active?
- Yes — Ccsd-Pc, LLC's NPI (1619820214) is active in the NPPES registry as of the last update on 2026-02-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.