OrganizationActive
Platinum Dental Group Lilburn LLC
NPI 1962634543 · Pediatric Dentistry · Lilburn, GA
Platinum Dental Group Lilburn LLC is a Pediatric Dentistry organization in Lilburn, GA (NPI 1962634543).
Provider details
- NPI number
- 1962634543
- Entity type
- Organization
- Primary specialty
- Pediatric DentistryDental Providers
- Parent organization
- Platinum Dental Group Lilburn LLC
- Organization subpart
- Yes
- Authorized official
- Mark Thebaut, Owner/Dentist(678) 990-6301
- License
- DN009113 (GA)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(85/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 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.
Ste a
Lilburn, GA 30047
Phone: (770) 709-0000
Fax: (770) 925-3302
Street-level locationGet directions
Mailing address
Po Box 1953
Lilburn, GA 30048-1953
Registry dates
- Enumerated
- 2009-08-17
- Last updated
- 2009-08-17
Frequently asked questions
- What is Platinum Dental Group Lilburn LLC's NPI number?
- Platinum Dental Group Lilburn LLC's National Provider Identifier (NPI) is 1962634543, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Platinum Dental Group Lilburn LLC?
- Platinum Dental Group Lilburn LLC is classified in the NPPES registry as Pediatric Dentistry (Dental Providers).
- Where is Platinum Dental Group Lilburn LLC located?
- Platinum Dental Group Lilburn LLC's practice location on file with NPPES is 609 Beaver Ruin Rd., Lilburn, GA 30047.
- What is Platinum Dental Group Lilburn LLC's phone number?
- The practice phone number listed in the NPPES registry for Platinum Dental Group Lilburn LLC is (770) 709-0000.
- Who is the authorized official for Platinum Dental Group Lilburn LLC?
- The authorized official listed on Platinum Dental Group Lilburn LLC's NPPES record is Mark Thebaut, Owner/Dentist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Platinum Dental Group Lilburn LLC's NPI active?
- Yes — Platinum Dental Group Lilburn LLC's NPI (1962634543) is active in the NPPES registry as of the last update on 2009-08-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.