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

Professional Dental Alliance of Atlanta Boulevard SE, LLC

Organization Dentist · NPI 1689239675

Professional Dental Alliance of Atlanta Boulevard SE, LLC is a Dentist in Atlanta, Georgia. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

465 Blvd SE Ste 207A
Atlanta, GA 30312-3483
Phone: (404) 624-1230
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X

Record details

NPI number1689239675
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lauren Howard — Credentialing Specialist · (724) 698-2029
NPI enumeratedMay 6, 2019
Last updated in NPPESMay 6, 2019
Mailing address11 S Mill St Ste 200, New Castle, PA 16101-3680

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