Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Parkside Pediatric and Orthodontic Care Inc

Organization Pediatric Dentistry · NPI 1366125395

Parkside Pediatric and Orthodontic Care Inc provides 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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