Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Parkside Pediatric and Orthodontic Care Inc

Organization Pediatric Dentistry · NPI 1366125395

Parkside Pediatric and Orthodontic Care Inc is a Pediatric Dentistry in Fayetteville, Georgia. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

155 Carnegie Pl Ste 201A
Fayetteville, GA 30214-3981
Phone: (678) 228-4266
Fax: (404) 521-4120
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X

Record details

NPI number1366125395
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tarvoria Russ — Operations Manager · (404) 631-7303
NPI enumeratedAugust 8, 2023
Last updated in NPPESAugust 8, 2023
Certification dateAugust 8, 2023
Mailing address155 Carnegie Pl Ste 201a, Fayetteville, GA 30214-3981

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