Provider Demographics
NPI:1295114890
Name:ATLANTA CENTER FOR DENTAL SLEEP MEDICINE
Entity type:Organization
Organization Name:ATLANTA CENTER FOR DENTAL SLEEP MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARVA O
Authorized Official - Middle Name:ORNESE
Authorized Official - Last Name:LUMPKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:770-444-9393
Mailing Address - Street 1:3621 VININGS SLOPE SE
Mailing Address - Street 2:SUITE 4350
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-4107
Mailing Address - Country:US
Mailing Address - Phone:770-444-9393
Mailing Address - Fax:
Practice Address - Street 1:3621 VININGS SLOPE SE
Practice Address - Street 2:SUITE 4350
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-4107
Practice Address - Country:US
Practice Address - Phone:770-444-9393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty