GWINNETT ORAL & MAXILLOFACIAL SURGERY, PC (NPI# 1205014578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205014578 |
| Entity Type | Organization |
| Organization Name | GWINNETT ORAL & MAXILLOFACIAL SURGERY, PC |
| Practice Address |
171 Gwinnett Dr Suite B Lawrenceville GA 30045-5686 |
| Practice Telephone | 7709957960 |
| Mailing Telephone | 7709957960 |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2008-02-08 |
| Authorized Official Name | DR. S LYLE ZUCK (PRESIDENT) |
| Authorized Official Telephone | 7709957960 |
| Authorized Official Credential | DMD, MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DN013444 | GA | Dental Providers |
| Street Address |
171 GWINNETT DR SUITE B |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30045-5686 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063895514 | Christiane Francisco | Dentist | 171 Gwinnett Dr, Suite C, Lawrenceville, GA 30046-5686 | 2015-07-01 |
| 1598028722 | Perrice Lakendra Murray | Dentist | 171 Gwinnett Dr, Lawrenceville, GA 30046-5686 | 2012-06-22 |
| 1780811224 | Christine Rosenberg Mcgowan | Dentist | 171 Gwinnett Dr, Suite A, Lawrenceville, GA 30045-5686 | 2009-06-11 |
| 1750585147 | Hubert Tucker Jr. | Dentist | 171 Gwinnett Dr, Suite C, Lawrenceville, GA 30045 | 2007-06-12 |
| 1891904538 | Carye Michah Riley | Dentist | 171 Gwinnett Dr, Suite C, Lawrenceville, GA 30045 | 2007-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285104315 | Shalanda Monique Booker | Counselor | 2940 Emerald Springs Drive, Lawrenceville, GA 30045 | 2018-12-02 |
| 1669957320 | Chantelle S Fuller | Behavioral Analyst | 805 Donington Cir, Lawrenceville, GA 30045 | 2018-09-28 |
| 1356836035 | Gad Health Care LLC | Home Health | 1140 Great Oaks Dr, Lawrenceville, GA 30045 | 2018-06-26 |
| 1346668662 | Eca Optical, LLC | Eyewear Supplier (Equipment, not the service) | 601-a Professional Drive, Ste 170, Lawrenceville, GA 30045 | 2014-04-03 |
| 1598102733 | Selena Fuller | Nurse Practitioner | 181 South Clayton Street, Lawrenceville, GA 30045 | 2013-05-29 |
| 1942555982 | Vida Michele James-bryant | Community Health Worker | 1309 Avington Glen Dr, Lawrenceville, GA 30045 | 2012-07-16 |
| 1770840639 | Rebecca Vinson D'angelo | Occupational Therapist | 1518 Great Shoals Cir, Lawrenceville, GA 30045 | 2012-04-17 |
| 1427346774 | Amanda Michelel Woods | Psychologist | 285 South Perry Street, Lawrenceville, GA 30045 | 2011-07-20 |
| 1790070563 | M & G Pharmacy Inc | Pharmacy | 100 Hurricane Shoals Rd Suite F, Lawrenceville, GA 30045 | 2011-06-09 |
| 1306146154 | Thanh Dau | Optometrist | 1250 Scenic Highway, Ste 1268, Lawrenceville, GA 30045 | 2010-10-27 |
| Find all providers in zip 30045 | ||||
| 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 |
|---|---|---|---|---|
| 1699780163 | Oral and Facial Surgery Associates, PC | Dentist | 745 Old Norcross Rd, Lawrenceville, GA 30045-4317 | 2006-07-30 |
| 1699746503 | Stacey Lyle Zuck | Dentist | 945 River Centre Pl, Suite 100, Lawrenceville, GA 30043-7340 | 2006-01-30 |
| 1689894289 | William Person Hipple | Dentist | 3100 Princeton Pike, Bldg 4 Suite F, Lawrenceville, NJ 08648-2300 | 2007-04-26 |
| 1356411920 | Jeannette Zaykeeah Robertson | Dentist | 2000 Riverside Pkwy, 200, Lawrenceville, GA 30043-5926 | 2006-11-09 |
| 1891875019 | Lawrenceville Oral & Maxillofacial Surgery | Dentist | 3100 Princeton Pike, Bldg 4 Suite F, Lawrenceville, NJ 08648-2300 | 2006-10-16 |
| 1609972157 | Earl F Cubbage | Dentist | 3100 Princeton Pike, Bldg. 4 - Suite F, Lawrenceville, NJ 08648-2300 | 2006-09-15 |
| 1053320028 | Robert E Ellis | Dentist | 745 Old Norcross Rd, Lawrenceville, GA 30045-4317 | 2006-08-07 |
| 1366451403 | Jess A Gardner | Dentist | 745 Old Norcross Rd, Lawrenceville, GA 30045-4317 | 2006-08-07 |
| 1144239203 | Sandeep V Pathak | Dentist | 745 Old Norcross Rd, Lawrenceville, GA 30045-4317 | 2006-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598370454 | Karin Davis, Dmd, PC | Dentist | 3630 Savannah Pl Ste 250, Duluth, GA 30096-6394 | 2020-09-08 |
| 1649740796 | Sandy Springs Oral Surgery, LLC | Dentist | 5555 Peachtree Dunwoody Rd Ste G56, Atlanta, GA 30342-1700 | 2018-12-02 |
| 1700354677 | Cobb Oral Surgery and Dental Implant Center PC | Dentist | 2155 Post Oak Tritt Rd Ste 500, Marietta, GA 30062-8609 | 2018-11-08 |
| 1245721216 | East Atlanta Oral, Implant and Facial Surgery Center | Dentist | 519 Memorial Dr Se Unit D1, Atlanta, GA 30312-2218 | 2018-05-24 |
| 1497261960 | Rockwell Oral and Facial Surgery LLC | Dentist | 675 N. Highland Ave Ne, Suite 100, Atlanta, GA 30306 | 2017-12-20 |
| 1225543515 | Oral & Facial Surgery of East Alabama, LLC | Dentist | 4405 N Stadium Drive, Suite A, Columbus, GA 31909 | 2017-12-08 |
| 1194271445 | Dina Amin | Dentist | 1365 Clifton,building B, Oral and Maxillofacial Surgery, Suite 2300, Atlanta, GA 30322 | 2016-08-28 |
| 1457735995 | Coastal Oral Surgery Associates | Dentist | 110 Office Park Ln, Suite 104, Saint Simons Island, GA 31522-6601 | 2015-07-15 |
| 1497140719 | Chelsea Elizabeth Johnson | Dentist | 4405 N Stadium Dr Ste A, Columbus, GA 31909-1884 | 2015-04-02 |
| 1386038396 | Timothy C Jaeger | Dentist | 1360 Caduceus Way Ste 101, Watkinsville, GA 30677-7300 | 2015-03-27 |
| Find all providers with the same taxonomy | ||||
| City | LAWRENCEVILLE |
| Zip Code | 30045 |
Please comment or provide details below to improve the information on GWINNETT ORAL & MAXILLOFACIAL SURGERY, PC.
| 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.