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Paul Ivey Nettles LLC

Pediatric Dentistry in College Park, GA · enumerated 2007 · authorized official Paul Nettles, President.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1063564078

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Registry record

Entity type Organization (Type 2)
Legal business name Paul Ivey Nettles LLC
Practice address 1177 Garden Walk Blvd, College Park, GA, 30349
Phone (770) 997-9090
Enumeration date Jan 18, 2007
Last updated in NPPES Sep 11, 2025

Taxonomy & classification

1223G0001X General Practice Dentistry Dental Providers · License 11589 (GA) Secondary
1223P0221X Pediatric Dentistry Dental Providers · License 6742 (GA) Primary

Authorized official

Name Paul Nettles
Title President
Phone (770) 997-9090

Other identifiers

Identifier Type State Issuer
0050949A Medicaid GA -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Paul Ivey Nettles LLC?
The NPI for Paul Ivey Nettles LLC is 1063564078, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Paul Ivey Nettles LLC?
NPPES lists Paul Nettles (President) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-09-11.