Mark D Thebaut DDS PC
Mark D Thebaut DDS PC is a healthcare organization registered as Pediatric Dentistry in Lilburn, GA, holding Type 2 (organization) NPI 1447377130 since 2007. The authorized official on file is Mark Thebaut, Owner.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1447377130 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Mark D Thebaut DDS PC |
| Other name | <Unavail> |
| Practice address | 609 BEAVER RUIN RD NW, SUITE A, Lilburn, GA, 30047 |
| Phone | 7709253301 |
| Fax | 7707090001 |
| Enumeration date | 2007-03-26 |
| Last updated in NPPES | 2008-06-18 |
Authorized official
| Name | Mark Thebaut |
|---|---|
| Title | Owner |
| Phone | 7709253301 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 1223P0221X | Pediatric Dentistry | Primary | 9113 | GA |
Copy-ready billing details
Provider: Mark D Thebaut DDS PC NPI: 1447377130 Taxonomy: 1223P0221X (Pediatric Dentistry) Address: 609 BEAVER RUIN RD NW, SUITE A, Lilburn, GA, 30047
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1255370565 | Mark Cohen | Individual | Periodontics | Lilburn, GA |
| 1245332238 | Mark Thebaut | Individual | Pediatric Dentistry | Lilburn, GA |
| 1831291574 | Gregory Clepper | Individual | General Practice Dentistry | Lilburn, GA |
| 1326501057 | Belema Abere | Individual | Pediatric Dentistry | Lilburn, GA |
Verify this record
Cross-check NPI 1447377130 against the authoritative CMS record: view Mark D Thebaut DDS PC on the official NPPES registry .
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. Read the full guide or validate an NPI number.
Frequently asked questions
What is a Type 2 NPI?
What type of organization is Mark D Thebaut DDS PC?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2008-06-18.