Gwinnett Childrens Dentistry – Pediatric Dentistry, NPI 1255665667

Gwinnett Childrens Dentistry is a healthcare provider. based in Lilburn, Georgia. specializing in Pediatric Dentistry. The NPI Number for Gwinnett Childrens Dentistry is 1255665667

Main info

Organization
Name
Gwinnett Childrens Dentistry
NPI
1255665667
Phone
(770) 925-3300
Address
609 BEAVER RUIN RD
Authorized Official
MR. MARK DENNY THEBAUT OWNER/DENTIST DDS
Enumeration Date
1 October 2009
Last Update Date
1 October 2009
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness80
Years active:16State licenses:0Digital endpointsUpdated within 12 months

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Provider Addresses for Gwinnett Childrens Dentistry

  • 609, Beaver Ruin Road, Luxomni, Lilburn, Gwinnett County, Georgia, 30047, United States

    SUITE A

    LILBURN, GA 30047

    Phone: (770) 925-3300

    Fax: (770) 925-3302

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

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Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30047)

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Reviews

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Frequently asked questions

What is the registry number for Gwinnett Childrens Dentistry?
The registry entry for Gwinnett Childrens Dentistry shows NPI 1255665667.
Is Gwinnett Childrens Dentistry's NPI status active today?
Active status means Gwinnett Childrens Dentistry's NPI record is not deactivated in the public file.
What services align with Gwinnett Childrens Dentistry's listing?
Gwinnett Childrens Dentistry's public classification highlights Pediatric Dentistry. Clinical services aligned with this taxonomy classification.
Can patients visit Gwinnett Childrens Dentistry in Lilburn, Georgia?
For routing, start with Lilburn, Georgia for Gwinnett Childrens Dentistry, then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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