MOUNTAIN VIEW ORAL SURGERY & DENTAL IMPLANTS LLC (NPI# 1104172741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104172741 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN VIEW ORAL SURGERY & DENTAL IMPLANTS LLC |
| Other Organization Name | MOUNTAIN VIEW ORAL SURGERY & DENTAL IMPLANTS |
| Practice Address |
121 Marble Mill Rd Nw Suite 202 Marietta GA 30060-7959 |
| Practice Telephone | 7702189135 |
| Practice Fax Number | 8662242735 |
| Mailing Telephone | 7702189135 |
| Mailing Fax Number | 8662242735 |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2012-08-01 |
| Authorized Official Name | MARK A CHISHOM (ORAL SURGEON) |
| Authorized Official Telephone | 7702189135 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DN014013 | GA | Dental Providers |
| Other Name | Type Code |
|---|---|
| Mountain View Oral Surgery & Dental Implants | Doing Business As Name - Organization |
| Street Address |
121 MARBLE MILL RD NW SUITE 202 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-7959 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477544591 | Jose O Rodriguez | Pediatrics | 121 Marble Mill Rd Nw, Ste 101, Marietta, GA 30060-7959 | 2005-10-31 |
| 1518263656 | Wellstar Medical Group, LLC | Pediatrics | 121 Marble Mill Rd Nw, Suite 101, Marietta, GA 30060-7959 | 2011-02-08 |
| 1588893200 | Sandra M Rodriguez | Pediatrics | 121 Marble Mill Rd Nw, Suite 101, Marietta, GA 30060-7959 | 2009-07-02 |
| 1164517017 | J D Whitener Jr. | Dentist | 121 Marble Mill Rd Nw, Suite 201, Marietta, GA 30060-1047 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1407477193 | Michael Cynil Daniel | Counselor | 698 N Marietta, Pkwy, Marietta, GA 30060 | 2020-05-04 |
| 1285253401 | Cameron Thomas Kennelly | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne Attn:gme, Marietta, GA 30060 | 2020-04-09 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1164064945 | Denise Alicia Mick | Registered Nurse | 677 Church St Wellstar Kennestone Hospital, Marietta, GA 30060 | 2019-10-12 |
| 1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
| 1346703212 | Caitlin Virginia Mueller | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 | 2019-04-08 |
| 1184187205 | Adero Francis | Student in an Organized Health Care Education/Training Program | Wellstar Kennestone Gme Internal Medicine Clinic, 833 Campbell Hill St Nw, Suite 250, Marietta, GA 30060 | 2019-04-08 |
| 1659832749 | Matthew Mozzo | Student in an Organized Health Care Education/Training Program | 677 Church Street / Lower Level, Gme Department / I.m., Marietta, GA 30060 | 2019-03-29 |
| 1245797430 | La'myia Spentz | Specialist | 109 Anderson St Ne, Suite 608, Marietta, GA 30060 | 2019-02-25 |
| Find all providers in zip 30060 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700354677 | Cobb Oral Surgery and Dental Implant Center PC | Dentist | 2155 Post Oak Tritt Rd Ste 500, Marietta, GA 30062-8609 | 2018-11-08 |
| 1386953222 | Dental Health Associates Oral Surgery Inc. | Dentist | 2900 Delk Rd Se Ste 1450, Marietta, GA 30067-5322 | 2010-09-27 |
| 1326041971 | James Ralph Smouse | Dentist | 1000 Johnson Ferry Rd, Bldg H, Marietta, GA 30068-5518 | 2005-05-27 |
| 1861884124 | Bryan Benton | Dentist | 1000 Johnson Ferry Rd Bldg H, Marietta, GA 30068-5518 | 2015-02-24 |
| 1528401445 | Joshua Michael Levy | Dentist | 1000 Johnson Ferry Rd Bldg H, Marietta, GA 30068-5518 | 2013-04-10 |
| 1194082321 | Christopher Hugh Kragor | Dentist | 1000 Johnson Ferry Rd Bldg H, Marietta, GA 30068 | 2012-04-12 |
| 1205192887 | Jorge Alberto Gonzalez-ocasio | Dentist | 1000 Johnson Ferry Rd Bldg H, Marietta, GA 30068-5518 | 2012-04-08 |
| 1982979753 | Richard Walls, Dmd,pc | Dentist | 2155 Post Oak Tritt Rd, Suite 500, Marietta, GA 30062-8620 | 2012-03-13 |
| 1154610665 | Michael Rosenthal | Dentist | 55 Whitcher St Ne, Suite 140, Marietta, GA 30060-1155 | 2011-04-05 |
| 1437460011 | Robert C Wunderle IIi | Dentist | 1000 Johnson Ferry Rd, Bldg H, Marietta, GA 30068-2114 | 2010-06-29 |
| Find all providers in MARIETTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.