Dentist Providers In Canton, Georgia

Search Dentist NPI records in Canton, GA

Search or browse through the NPI records of dentist registered healthcare providers with a business address in Canton, GA. The listings include accepted insurance information, Medicare acceptance status, and PECOS enrollment data. The total number of NPI records is 88, of which 27 are registered as organizations and 61 as individuals. A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

69% Individuals

31% Organizations

30% Female

40% Male

69% Individual Providers (61)31% Medical Organizations (27)30% Female Providers (26)40% Male Providers (35)

Map of Providers

We have mapped the Dentist providers in Canton, GA to visually represent the practice location of each individual or organization. Click on any of the the pins to see the provider details at that location.

List of Providers

Table of Dentist NPI Profiles in Canton, GA
NPI	Name	Address	Insurance	Medicare	PECOS
1003233107	HEARTLAND DENTAL CARE OF GEORGIA FAMILY DENTAL OF CANTON (Organization)	3237 SIXES RD CANTON, GA 30114 (770) 450-1689	Ambetter from Absolute Total Care Ambetter Health Ambetter of Alabama Ambetter of North Carolina Ambetter of Tennessee WellCare of North Carolina	Non-Participating Provider	NO
1003823741	STEPHEN C HUTCHINS (Individual)	218 RIVERSTONE DR CANTON, GA 30114 (770) 479-3846		Non-Participating Provider	NO
1013171438	SHALETHA M BOLDEN (Individual)	1425 RIVERSTONE PKWY STE 200 CANTON, GA 30114 (770) 479-0600	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1053930289	EDMUND WARREN GUBLER (Individual)	2020 CUMMING HWY STE 100 CANTON, GA 30115 (770) 741-0439	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO DeltaCare USA EMI Health Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental University of Utah Health Plans	Non-Participating Provider	YES
1063427474	DAMERON FAMILY DENTISTRY (Organization)	6199 HICKORY FLAT HWY SUITE 130 CANTON, GA 30115 (770) 345-8646		Non-Participating Provider	NO
1083283865	SYDNEY OKONOBOH (Individual)	2030 CUMMING HWY STE 110 CANTON, GA 30115 (678) 818-8480	Ambetter from Absolute Total Care Ambetter Health Ambetter of Alabama Ambetter of North Carolina Ambetter of Tennessee Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Companion Life Insurance Company Dominion National Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare WellCare of North Carolina	Non-Participating Provider	NO
1083778989	BRENDA GAIL FRITZ (Individual)	104 PROMINENCE POINT PKWY SUITE 102 CANTON, GA 30114 (770) 345-2551		Non-Participating Provider	NO
1093149486	CANTON SMILES DENTISTRY, PC CANTON SMILES DENTISTRY (Organization)	1425 RIVERSTONE PKWY STE 200 CANTON, GA 30114 (770) 479-0600	Ambetter from Absolute Total Care Ambetter Health Ambetter of Alabama Ambetter of North Carolina Ambetter of Tennessee WellCare of North Carolina	Non-Participating Provider	NO
1104847136	LEWIS FAMILY DENTISTRY, LLC (Organization)	7768 CUMMING HWY SUITE 100 CANTON, GA 30114 (678) 493-2204		Non-Participating Provider	NO
1114007887	WILLIAM DIRK RUSSELL (Individual)	8014 CUMMING HWY SUITE 401 CANTON, GA 30115 (770) 345-2010	Humana	Non-Participating Provider	NO
1124105507	GREG ELWELL, D.M.D., P.C. (Organization)	24 WALESKA ST CANTON, GA 30114 (770) 479-5569		Non-Participating Provider	NO
1134216898	SCOTT VIDAR MERRITT (Individual)	3755 SIXES RD STE 100 CANTON, GA 30114 (770) 704-1812		Non-Participating Provider	NO
1134448301	LEIGH ANN PATEL (Individual)	12420 CUMMING HWY STE 306 CANTON, GA 30115 (678) 947-3600	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental	Non-Participating Provider	NO
1154216216	NIANG MUANG (Individual)	1425 RIVERSTONE PKWY # 200 CANTON, GA 30114 (770) 479-0600		Non-Participating Provider	NO
1164101945	JONGBIN WIE (Individual)	1425 RIVERSTONE PKWY # 200 CANTON, GA 30114 (770) 479-0600	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1174386502	SAGE DENTAL GROUP OF GEORGIA, LLC (Organization)	3750 SIXES RD CANTON, GA 30114 (561) 999-9650		Non-Participating Provider	NO
1184146318	CHEROKEE FAMILY DENTAL EAST CHEROKEE LLC CHEROKEE FAMILY DENTAL EAST CHEROKEE (Organization)	7768 CUMMING HWY STE 100 CANTON, GA 30115 (678) 493-2204		Non-Participating Provider	NO
1184830614	DOUGLAS DICKEY (Individual)	8701 KNOX BRIDGE HWY CANTON, GA 30114 (770) 479-3202		Non-Participating Provider	NO
1184891780	WILLIAM GREG ELWELL (Individual)	24 WALESKA ST CANTON, GA 30114 (770) 479-5569		Non-Participating Provider	NO
1194155986	CHEROKEE FAMILY DENTAL, LLC (Organization)	2920 MARIETTA HWY SUITE 146 CANTON, GA 30114 (770) 704-6987		Non-Participating Provider	NO
1205032141	JAMES A UHLIN (Individual)	327 HEIGHTS PL CANTON, GA 30114 (770) 479-1444		Non-Participating Provider	NO
1205526951	MADISON BUTLER (Individual)	104 PROMINENCE POINT PKWY STE 100 CANTON, GA 30114 (770) 704-6987	Humana	Non-Participating Provider	NO
1215442017	LINDSAY MARIE FOREMAN (Individual)	1425 RIVERSTONE PKWY UNIT 200 CANTON, GA 30114 (770) 479-0600	Ambetter from Absolute Total Care Ambetter Health Ambetter of Alabama Ambetter of North Carolina Ambetter of Tennessee Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare WellCare of North Carolina	Non-Participating Provider	NO
1225289374	MARK J GOCH (Individual)	230 RIVERSTONE PKWY STE A CANTON, GA 30114 (770) 479-5425	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1245651769	NIRALI PROCTER, DMD, LLC (Organization)	205 WALESKA RD CANTON, GA 30114 (770) 479-1717		Non-Participating Provider	NO
1245915958	KAITLIN ENGLISH YOUNG (Individual)	104 PROMINENCE POINT PKWY STE 100 CANTON, GA 30114 (770) 704-6987		Non-Participating Provider	NO
1255439220	JAMES H SHORR (Individual)	12875 CUMMING HWY SUITE 101 CANTON, GA 30115 (678) 845-0366	Aetna CVS Health Ambetter Health Ambetter of Alabama Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Cigna Healthcare Delta Dental Dominion National EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1255580791	STEPHEN MATTHEW PHELPS (Individual)	205 WALESKA ROAD SUITE 2-A CANTON, GA 30114 (770) 479-3713		Non-Participating Provider	YES
1285029157	AMBRE A. EHLERT KRAGOR (Individual)	217 WHITE OAK DR CANTON, GA 30114 (206) 854-8585	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	YES
1295123685	STUART LOOS DDD LLC (Organization)	1353 RIVERSTONE PKWY SUITE 130 CANTON, GA 30114 (770) 345-8300		Non-Participating Provider	NO
1306729793	CANTON ORTHODONTICS LLC (Organization)	150 PROMINENCE POINT PKWY STE 300 CANTON, GA 30114 (770) 800-8300		Non-Participating Provider	NO
1306982921	JOHN DAVID PEACOCK (Individual)	24 WALESKA ST CANTON, GA 30114 (770) 479-5569		Non-Participating Provider	YES
1326109216	ROGER PATRICK STEWART (Individual)	2920 MARIETTA HWY SUITE 146 CANTON, GA 30114 (770) 704-6987		Non-Participating Provider	NO
1336154749	CHARLES EMERY DAMERON (Individual)	6199 HICKORY FLAT HWY SUITE 130 CANTON, GA 30115 (770) 345-8646		Non-Participating Provider	NO
1336435726	NORTH METRO ORAL & MAXILLOFACIAL SURGERY, LLC (Organization)	4508 HOLLY SPGS PKWY STE 1 CANTON, GA 30115 (770) 345-8118		Non-Participating Provider	NO
1336497403	NIA DENTISTRY LLC NIA PEDIATRIC DENTISTRY AND FAMILY ORTHOPEDICS (Organization)	150 PROMINENCE POINT PKWY SUITE 500 CANTON, GA 30114 (770) 479-9999	UnitedHealthcare	Non-Participating Provider	NO
1346841624	MEGAN DAVIDSON (Individual)	1425 RIVERSTONE PKWY STE 200 CANTON, GA 30114 (770) 479-0600	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1356364665	JEFFREY MILES MAZZAWI (Individual)	205 WALESKA RD SUITE 2-B CANTON, GA 30114 (770) 479-1717		Non-Participating Provider	NO
1386043123	MEGAN HENRY SMITH (Individual)	2030 CUMMING HWY CANTON, GA 30115 (404) 974-9000	Ambetter from Absolute Total Care Ambetter Health Ambetter of Alabama Ambetter of North Carolina Ambetter of Tennessee Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare WellCare of North Carolina	Non-Participating Provider	NO
1396418976	ASHLEY WEAVER (Individual)	3750 SIXES RD CANTON, GA 30114 (470) 863-2049	Ambetter from Absolute Total Care Ambetter Health Ambetter of Alabama Ambetter of North Carolina Ambetter of Tennessee Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare WellCare of North Carolina	Non-Participating Provider	YES
1407993827	PRIYA N DIXIT (Individual)	150 PROMINENCE POINT PKWY STE 500 CANTON, GA 30114 (770) 479-9999	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1437398666	CANTON PEDIATRIC DENTISTRY PC (Organization)	3395 SIXES RD SUITE 140 CANTON, GA 30114 (678) 763-2600		Non-Participating Provider	NO
1437573748	DENTISTRY AT HICKORY FLAT PC DENTISTRY AT HICKORY FLAT (Organization)	6199 HICKORY FLAT HWY STE 130 CANTON, GA 30115 (770) 213-8166		Non-Participating Provider	NO
1447596655	KALLIE LAW BROCK (Individual)	205 WALESKA RD SUITE 2A CANTON, GA 30114 (770) 479-3713		Non-Participating Provider	YES
1457353419	ELIZABETH TOWNLEY LEWIS (Individual)	7768 CUMMING HIGHWAY SUITE 100 CANTON, GA 30114 (678) 493-2204	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Renaissance Dental	Non-Participating Provider	YES
1467894824	ELIJAH HOYT STEPHENS (Individual)	2020 CUMMING HWY STE 100 CANTON, GA 30115 (912) 580-8511	Ambetter from Absolute Total Care Ambetter Health Ambetter of Alabama Ambetter of North Carolina Ambetter of Tennessee Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Renaissance Dental UnitedHealthcare WellCare of North Carolina	Non-Participating Provider	NO
1477720076	LOUIS MICHAEL COX (Individual)	24 WALESKA ST CANTON, GA 30114 (770) 479-5569		Non-Participating Provider	NO
1487734067	ANDREA W. RUSSELL (Individual)	8014 CUMMING HWY SUITE 401 CANTON, GA 30115 (770) 345-2010	Humana	Non-Participating Provider	NO
1487739884	VINCENT MICHAEL LLOYD (Individual)	132 RIVERSTONE TERRACE SUITE 100 CANTON, GA 30114 (770) 720-3280	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1487782132	NELSON G WOO (Individual)	4508 HOLLY SPRINGS PARKWAY SUITE 2 CANTON, GA 30115 (770) 213-1726		Non-Participating Provider	NO
1508873142	STEPHEN C. HUTCHINS D.D.S. P.C. (Organization)	218 RIVERSTONE DR CANTON, GA 30114 (770) 479-3846		Non-Participating Provider	NO
1508953233	SWORDS AND PHELPS (Organization)	205 WALESKA RD STE 2A CANTON, GA 30114 (770) 479-3713		Non-Participating Provider	NO
1518116946	JOHN T PHELPS (Individual)	205 WALESKA ROAD SUITE 2-A CANTON, GA 30114 (770) 479-3713		Non-Participating Provider	NO
1558568337	AZI SOLTANI NIA (Individual)	150 PROMINENCE POINT PKWY SUITE 500 CANTON, GA 30114 (770) 479-9999	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1568518090	BENJAMIN ANDREW SMITH (Individual)	147 REINHARDT COLLEGE PKWY CANTON, GA 30114 (770) 479-5569	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Humana	Non-Participating Provider	NO
1588221774	ADA JULIA REYES (Individual)	3395 SIXES RD STE 140 CANTON, GA 30114 (770) 720-0079	Ambetter from Absolute Total Care Ambetter Health Ambetter of Alabama Ambetter of North Carolina Ambetter of Tennessee Humana WellCare of North Carolina	Non-Participating Provider	NO
1598893240	NELSON G. WOO, D.M.D., P.C. (Organization)	147 REINHARDT COLLEGE PARKWAY SUITE 10 CANTON, GA 30114 (770) 345-3051		Non-Participating Provider	NO
1609208461	RUXIMAR HERNANDEZ LINKOUS (Individual)	218 RIVERSTONE DR CANTON, GA 30114 (678) 643-4233	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1639362445	CHEROKEE CHILDREN'S DENTISTRY (Organization)	205 WALESKA RD SUITE 2B CANTON, GA 30114 (404) 479-1717		Non-Participating Provider	NO
1669450649	NIRALI PATEL PROCTER (Individual)	205 WALESKA RD SUITE 2B CANTON, GA 30114 (770) 479-1717	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1679241269	WOODMONT DENTAL LLC (Organization)	7768 CUMMING HWY SUITE 100 CANTON, GA 30115 (678) 493-2204		Non-Participating Provider	NO
1689754202	DIRK RUSSELL D.M.D., P.C. (Organization)	8014 CUMMING HWY SUITE 401 CANTON, GA 30115 (770) 345-2010		Non-Participating Provider	NO
1699924027	EDWIN IRA SWORDS (Individual)	205 WALESKA ROAD SUITE 2-A CANTON, GA 30114 (770) 479-3713		Non-Participating Provider	YES
1699973511	FARSHID HAMIDI NIA (Individual)	150 PROMINENCE POINT PKWY SUITE- 500 CANTON, GA 30114 (770) 479-9999	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1700058302	NORTHWEST ENDODONTIC SPECIALISTS, P.C. CANTON OFFICE (Organization)	2205 RIVERSTONE BLVD SUITE 205 CANTON, GA 30114 (678) 493-6693		Non-Participating Provider	NO
1710546148	GEORGIA DENTAL PROFESSIONALS, PC MACEDONIA DENTAL CARE (Organization)	8022 CUMMING HWY CANTON, GA 30115 (470) 863-2755	Ambetter from Absolute Total Care Ambetter Health Ambetter of Alabama Ambetter of North Carolina Ambetter of Tennessee WellCare of North Carolina	Non-Participating Provider	NO
1720143811	ANTHEA DREW (Individual)	205 WALESKA RD SUITE 2-B CANTON, GA 30114 (404) 275-8443		Non-Participating Provider	NO
1720270309	POYA MOGHADAM (Individual)	1810 CUMMING HWY SUITE 900 CANTON, GA 30114 (678) 880-0087	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1730753823	GISELLE SADEGHI (Individual)	1353 RIVERSTONE PKWY STE 130 CANTON, GA 30114 (770) 345-8300	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental	Non-Participating Provider	NO
1740527506	ALPESH PATEL (Individual)	12420 CUMMING HWY STE 306 CANTON, GA 30115 (678) 947-3600	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1740636166	RICKY PATEL (Individual)	8701 KNOX BRIDGE HWY CANTON, GA 30114 (205) 934-2700		Non-Participating Provider	YES
1770650848	JOHN W CAREY (Individual)	4508 HOLLY SPRGS PKWY STE 1 CANTON, GA 30115 (770) 345-8118	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1770929119	LAKE POINTE DENTAL INC LAKE POINTE DENTAL CANTON (Organization)	6615 HICKORY FLAT HWY SUITE 100 CANTON, GA 30115 (678) 383-4948		Non-Participating Provider	NO
1790790103	LAURA LYNN DAMERON (Individual)	6199 HICKORY FLAT HWY SUITE 130 CANTON, GA 30115 (770) 345-8646		Non-Participating Provider	NO
1821441478	DAVID WILDER (Individual)	3237 SIXES RD CANTON, GA 30114 (678) 880-9775	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1831347665	NICHOLAS JOSEPH KIRKPATRICK (Individual)	8701 KNOX BRIDGE HWY CANTON, GA 30114 (770) 479-3202	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BlueCross BlueShield of Tennessee	Non-Participating Provider	NO
1841524295	CANTON DENTAL, LLC (Organization)	230 RIVERSTONE PKWY STE A CANTON, GA 30114 (770) 479-5425	Ambetter from Absolute Total Care Ambetter Health Ambetter of Alabama Ambetter of North Carolina Ambetter of Tennessee WellCare of North Carolina	Non-Participating Provider	NO
1881322261	RITA OKOLO (Individual)	2030 CUMMING HWY STE 110 CANTON, GA 30115 (404) 974-9000	Aetna CVS Health Ambetter from Absolute Total Care Ambetter of North Carolina Ambetter of Tennessee Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of NC Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Dominion National Florida Combined Life Guardian Humana Paramount Paramount Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare WellCare of North Carolina	Non-Participating Provider	NO
1891267316	CANTON MARKETPLACE DENTISTRY LLC (Organization)	1810 CUMMING HWY STE 900 CANTON, GA 30115 (770) 780-2465		Non-Participating Provider	NO
1902536600	JENNIFER LENNING (Individual)	205 WALESKA RD STE 2A CANTON, GA 30114 (770) 479-3713		Non-Participating Provider	NO
1902873276	CARL M. RUSSELL (Individual)	6488 HICKORY FLAT HWY CANTON, GA 30115 (770) 720-8138	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	YES
1912645615	ARTHUR STUART LOOS (Individual)	1353 RIVERSTONE PKWY STE 130 CANTON, GA 30114 (770) 345-8300		Non-Participating Provider	NO
1912690165	BASMAH AREF (Individual)	8701 KNOX BRIDGE HWY CANTON, GA 30114 (770) 479-3202	Anthem Blue Cross and Blue Shield Florida Combined Life Humana UnitedHealthcare	Non-Participating Provider	NO
1932886181	LOGAN CHARLES MCINTIRE (Individual)	3237 SIXES RD CANTON, GA 30114 (678) 880-9775	Ambetter from Absolute Total Care Ambetter Health Ambetter of Alabama Ambetter of North Carolina Ambetter of Tennessee Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare WellCare of North Carolina	Non-Participating Provider	NO
1942495031	NIKOLE DAWN ADAMSON (Individual)	230 RIVERSTONE PKWY STE A CANTON, GA 30114 (770) 479-5425		Non-Participating Provider	NO
1952520751	HICKORY FLAT ORTHODONTICS, PC (Organization)	6488 HICKORY FLAT HWY CANTON, GA 30115 (770) 720-8138		Non-Participating Provider	NO
1962239129	RYAN ANTHONY SMITH (Individual)	3755 SIXES RD STE 200 CANTON, GA 30114 (770) 905-0300		Non-Participating Provider	NO
1962678425	GERALD A SMITH (Individual)	3755 SIXES RD SUITE 200 CANTON, GA 30114 (770) 704-7157	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Renaissance Dental	Non-Participating Provider	NO

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