PAUL IVEY NETTLES LLC
PAUL IVEY NETTLES LLC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1063564078, based in College Park, GA. The organization lists 2 taxonomy classifications, with Pediatric Dentistry recorded as primary.
Getting there
The practice address on file is 1177 GARDEN WALK BLVD, College Park, GA 30349. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 6742 | GA | Pediatric Dentistry primary |
| 11589 | GA | General Practice Dentistry |
This provider holds licence 6742 issued in GA. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
This NPI does not appear in the PECOS Medicare enrolment file. Providers who do not bill Medicare — or who bill only through a group's enrolment — will not appear here. It is not a sign of any problem with the registration.
What Pediatric Dentistry covers
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. NUCC Health Care Provider Taxonomy, code 1223P0221X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 1223P0221X | Pediatric Dentistry Pediatric Dentistry | 6742 | GA | primary |
| 1223G0001X | General Practice Dentistry General Practice | 11589 | GA |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1063564078 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Jan 18, 2007 |
| Last updated | Sep 11, 2025 |
| Status | Active |
| Practice address |
1177 GARDEN WALK BLVD College Park, GA 30349 (770) 997-9090 |
| Mailing address |
730 HIGHMEADE TER Alpharetta, GA 30005 |
| Other identifiers |
0050949A
(GA) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 0 | 6 | 3 | 5 | 6 | 4 | 0 | 7 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 0 | 3 | 3 | 1 | 6 | 8 | 0 | 5 |
Sum = 52 · next multiple of 10 = 60 · check digit = 8 · actual last digit = 8
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.