PLATINUM DENTAL GROUP LILBURN, LLC – Pediatric Dentistry, NPI 1609100015

PLATINUM DENTAL GROUP LILBURN, LLC is a healthcare provider. based in Lilburn, Georgia. specializing in Pediatric Dentistry. The NPI Number for PLATINUM DENTAL GROUP LILBURN, LLC is 1609100015

Main info

Organization
Name
PLATINUM DENTAL GROUP LILBURN, LLC
NPI
1609100015
Phone
(770) 709-0000
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
Completeness75
Years active:16State licenses:0Digital endpointsOther names

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Provider Addresses for PLATINUM DENTAL GROUP LILBURN, LLC

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

    SUITE A

    LILBURN, GA 30047

    Phone: (770) 709-0000

    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

Source: CMS public data · Not endorsed by CMS ·

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 ·

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

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

Does PLATINUM DENTAL GROUP LILBURN, LLC share an NPI with anyone else?
NPI numbers are unique to each provider or organization — PLATINUM DENTAL GROUP LILBURN, LLC uses 1609100015.
Is PLATINUM DENTAL GROUP LILBURN, LLC still practicing?
PLATINUM DENTAL GROUP LILBURN, LLC is currently listed as active in the public NPI registry.
What is PLATINUM DENTAL GROUP LILBURN, LLC's specialty?
The listing groups PLATINUM DENTAL GROUP LILBURN, LLC with Pediatric Dentistry. Clinical services aligned with this taxonomy classification.
What address line appears for PLATINUM DENTAL GROUP LILBURN, LLC?
PLATINUM DENTAL GROUP LILBURN, LLC's geographic hint is Lilburn, Georgia in our summary view.
Is the information about PLATINUM DENTAL GROUP LILBURN, LLC up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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