Provider Demographics
NPI:1548436082
Name:JANET J. STILES DDS LLC
Entity type:Organization
Organization Name:JANET J. STILES DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:J
Authorized Official - Last Name:STILES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:404-688-5668
Mailing Address - Street 1:75 PIEDMONT AVE
Mailing Address - Street 2:# 1166
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-2544
Mailing Address - Country:US
Mailing Address - Phone:404-688-5668
Mailing Address - Fax:
Practice Address - Street 1:75 PIEDMONT AVE
Practice Address - Street 2:# 1166
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-2544
Practice Address - Country:US
Practice Address - Phone:404-688-5668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8453261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00136287BMedicaid