NPI age
19 years
Enumerated 2007-03-26
● Active Type 2 · Organization
Mark D Thebaut DDS Pc
Mark D Thebaut DDS Pc 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
Thebaut
Owner
Last NPPES update
2008-06-18
Source: monthly bulk 2026-05
How this organization compares
Across 539 active dentist providers in Georgia.
NPI age
19 years
↑ 3 yr above median
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, Suite A
Lilburn, GA 300473401
Mailing address
609 Beaver Ruin Rd Nw, Suite A
Lilburn, GA 300473401
Authorized official
Mark D Thebaut, DDS
Owner
📞 7709253301
Individual providers at this organization
4 individual providers on file at this primary practice address.
- Belema Abere, DMD Dentist NPI 1326501057
- Gregory Clepper, DMD Dentist NPI 1831291574
- Mark Cohen, D.D.S. Dentist NPI 1255370565
- Mark Thebaut, DDS Dentist NPI 1245332238
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.
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Gwinnett Childrens Dentistry
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 →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.