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Platinum Dental Group Gainesville, LLC

Pediatric Dentistry in Gainesville, GA · enumerated 2009 · authorized official Mark Thebaut, Owner/Dentist.

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

National Provider Identifier

1083948491

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Registry record

Entity type Organization (Type 2)
Legal business name Platinum Dental Group Gainesville, LLC
Practice address 3535 Thompson Bridge Rd, Gainesville, GA, 30506
Phone (770) 534-5374
Fax (770) 534-5591
Enumeration date Oct 1, 2009
Last updated in NPPES Oct 1, 2009

Taxonomy & classification

1223G0001X General Practice Dentistry Dental Providers Secondary
1223P0221X Pediatric Dentistry Dental Providers Primary

Authorized official

Name Mark Thebaut
Title Owner/Dentist
Phone (678) 990-6301

Other identifiers

Identifier Type State Issuer
000185875H Medicaid GA -
232076497C Medicaid GA -
149199935C Medicaid GA -
177273740C Medicaid GA -
151700972D Medicaid GA -
591447276D 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

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2009-10-01. Verify at npiregistry.cms.hhs.gov.
Where is Platinum Dental Group Gainesville, LLC located?
The practice location on file with NPPES is in Gainesville, GA.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2009-10-01.