NPI age
19 years
Enumerated 2007-03-26
● Active Type 2 · Organization
Platinum Dental Of Lilburn
Platinum Dental Of Lilburn is 1 of 4309 dentist organizations in Georgia.
Primary specialty
Dentist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Thebaut
Owner
Last NPPES update
2009-03-25
Source: monthly bulk 2026-05
How this organization compares
Across 4309 active dentist providers in Georgia.
NPI age
19 years
≈ at median (18 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-03Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
609 Beaver Ruin Rd Nw Ste A
Lilburn, GA 300473401
Mailing address
609 Beaver Ruin Rd Nw Ste A
Lilburn, GA 300473401
Authorized official
Mark D Thebaut, DDS
Owner
📞 7707090000
Individual providers at this organization
4 individual providers on file at this primary practice address.
- Aleida Frometa-Preval, D.A. Dental Assistant NPI 1306065271
- Maxine Handsor, D.A. Dental Assistant NPI 1467671339
- Dawn Rosales Dental Assistant NPI 1891915633
- Christina Watts, D.A. Dental Assistant NPI 1649499500
Specialties
-
Dentist PrimaryA general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Platinum Dental Lilburn, LLC
Practice context
Multi-provider organization. 4 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 →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.