EAST ATLANTA ORAL, IMPLANT AND FACIAL SURGERY CENTER (NPI# 1245721216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245721216 |
| Entity Type | Organization |
| Organization Name | EAST ATLANTA ORAL, IMPLANT AND FACIAL SURGERY CENTER |
| Practice Address |
519 Memorial Dr Se Unit D1 Atlanta GA 30312-2218 |
| Mailing Address |
2115 Wolbert Trl Marietta GA 30062-7908 |
| Practice Telephone | 4044836316 |
| Mailing Telephone | 7703823536 |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2018-05-24 |
| Authorized Official Name | JEREMY TARVER (OWNER) |
| Authorized Official Telephone | 7703823536 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| Street Address |
519 MEMORIAL DR SE UNIT D1 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30312-2218 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770108516 | Bita Ranjbari | Physician Assistant | 659 Auburn Ave Se, Suite 505, Atlanta, GA 30312 | 2020-06-08 |
| 1609439629 | Adeyinka Edward Adeniyi | Student in an Organized Health Care Education/Training Program | Wellstar Atlanta Medical Center, 303 Parkway Drive Ne, 4th Floor, Internal Medicine Department, Atlanta, GA 30312 | 2019-04-16 |
| 1003378670 | James Spratt IIi | Student in an Organized Health Care Education/Training Program | 303 Parkway Drive, Ne, 4th Floor, Wellstar Atlanta Medical Center Department of Orthopaed, Atlanta, GA 30312 | 2019-04-03 |
| 1659833440 | Derrick Edward Wendler | Student in an Organized Health Care Education/Training Program | Wellstar Atlanta Medical Center Dpt of Orthopaedics, 303 Parkway Drive Ne, 4th Floor, Atlanta, GA 30312 | 2019-04-02 |
| 1336631266 | The Atlanta Small Business Training Consortium, Inc. | Local Education Agency (LEA) | 250 Georgia Ave Se Ste 207a, Atlanta, GA 30312 | 2018-06-06 |
| 1669960134 | Derek Mccranie | Student in an Organized Health Care Education/Training Program | 303 Parkway Drive, Atlanta, FL 30312 | 2018-04-30 |
| 1336646223 | Amy Ruth Williams | Nurse Practitioner | 383 Ralph Mcgill Blvd Ne Apt D, Atlanta, GA 30312 | 2018-04-09 |
| 1730689183 | Lisa Marie Margavage | Chiropractor | 720 Ralph Mcgill Blvd Ne Unit 210, Atlanta, GA 30312 | 2018-02-12 |
| 1922518836 | Rodney Aldridge | Registered Nurse | 250 Georgia Avenue, Suite 206, Atlanta, GA 30312 | 2017-10-05 |
| 1629599279 | Huda Hashim Elsamani Elsheikh | Student in an Organized Health Care Education/Training Program | 303 Parkway Dr Ne, Wellstar Atlanta Medical Center, Dept of Graduate Medical Education, Internal Medicine, Atlanta, GA 30312 | 2017-07-05 |
| Find all providers in zip 30312 | ||||
| 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 |
|---|---|---|---|---|
| 1649740796 | Sandy Springs Oral Surgery, LLC | Dentist | 5555 Peachtree Dunwoody Rd Ste G56, Atlanta, GA 30342-1700 | 2018-12-02 |
| 1497261960 | Rockwell Oral and Facial Surgery LLC | Dentist | 675 N. Highland Ave Ne, Suite 100, Atlanta, GA 30306 | 2017-12-20 |
| 1194271445 | Dina Amin | Dentist | 1365 Clifton,building B, Oral and Maxillofacial Surgery, Suite 2300, Atlanta, GA 30322 | 2016-08-28 |
| 1841697539 | Brittney Barrow | Dentist | 60 11th St Ne Apt 2021, Atlanta, GA 30309-4388 | 2014-11-25 |
| 1083889661 | Amy Diane Kuhmichel | Dentist | 3280 Howell Mill Rd Nw Ste 221, Atlanta, GA 30327-4100 | 2008-04-24 |
| 1255517769 | Abtin Shahriari | Dentist | 182 Robin Hood Rd Ne, Atlanta, GA 30309-2658 | 2008-01-15 |
| 1033153671 | Joyce T Lee | Dentist | 1175 Peachtree St Ne, Suite 1202, Atlanta, GA 30361-6202 | 2006-06-15 |
| 1063471324 | Peachtree Oral & Maxillofacial Surgery Associates | Dentist | 550 Pharr Rd Ne, Suite 325, Atlanta, GA 30305-3428 | 2006-03-23 |
| 1134123524 | Lee Mclean Whitesides | Dentist | 5576 Chamblee-dunwoody Rd, Atlanta, GA 30338 | 2005-06-13 |
| 1891252227 | Northside Oral Surgery Center LLC | Dentist | 4700 Chamblee Dunwoody Rd, Atlanta, GA 30338-6054 | 2019-02-21 |
| Find all providers in ATLANTA | ||||
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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.