OrganizationActive
Platinum Dental Group Surgical Center
NPI 1891813408 · Pediatric Dentistry · Roswell, GA
Platinum Dental Group Surgical Center is a Pediatric Dentistry organization in Roswell, GA (NPI 1891813408).
Provider details
- NPI number
- 1891813408
- Entity type
- Organization
- Primary specialty
- Pediatric DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Mark Thebaut, Owner(770) 751-3115
- License
- 9113 (GA)
Specialties & taxonomies
Dental Providers
Dental Providers
Profile Score
Detailed profile(89/100 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
1345 Hembree Rd
Roswell, GA 30076-3816
Phone: (770) 751-3115
Fax: (678) 990-1065
Street-level locationGet directions
Mailing address
1345 Hembree Rd
Roswell, GA 30076-3816
Other names (DBA / former)
- Former legal business name
- Platinum Dental Group Surgical Center, LLC
Registry dates
- Enumerated
- 2007-03-26
- Last updated
- 2025-09-11
Frequently asked questions
- What is Platinum Dental Group Surgical Center's NPI number?
- Platinum Dental Group Surgical Center's National Provider Identifier (NPI) is 1891813408, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Platinum Dental Group Surgical Center?
- Platinum Dental Group Surgical Center is classified in the NPPES registry as Pediatric Dentistry (Dental Providers).
- Where is Platinum Dental Group Surgical Center located?
- Platinum Dental Group Surgical Center's practice location on file with NPPES is 1345 Hembree Rd, Roswell, GA 30076-3816.
- What is Platinum Dental Group Surgical Center's phone number?
- The practice phone number listed in the NPPES registry for Platinum Dental Group Surgical Center is (770) 751-3115.
- Who is the authorized official for Platinum Dental Group Surgical Center?
- The authorized official listed on Platinum Dental Group Surgical Center'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 Group Surgical Center's NPI active?
- Yes — Platinum Dental Group Surgical Center's NPI (1891813408) is active in the NPPES registry as of the last update on 2025-09-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.