NPI age
15 years
Enumerated 2010-07-16
● Active Type 2 · Organization
Pediatric Dental Center Of Georgia
Pediatric Dental Center Of Georgia is 1 of 539 dentist organizations in Georgia.
Primary specialty
Dentist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Webster
Owner
Last NPPES update
2024-04-26
Source: monthly bulk 2026-05
How this organization compares
Across 539 active dentist providers in Georgia.
NPI age
15 years
≈ at median (16 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2010 → 2026
2010-07Enumerated in NPPES
2010
2026
Where they practice
Primary practice location
820 Love Ave Ste A
Tifton, GA 317944000
Mailing address
820 Love Ave Ste A
Tifton, GA 317944000
Authorized official
Luther David Webster, D.M.D
Owner
📞 2292383787
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Aksana Marshall, D.M.D, M.S. Dentist NPI 1942636535
- Luther Webster, DMD Dentist NPI 1205092848
Specialties
-
Dentist PrimaryAn age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 582837896B |
Practice context
Multi-provider organization. 2 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.