KRAGOR ORTHODONTICS LLC (NPI# 1306203427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1306203427 |
Entity Type | Organization |
Organization Name | KRAGOR ORTHODONTICS LLC |
Practice Address |
1816 Eagle Dr Suite 100-b Woodstock GA 30189-8272 |
Practice Telephone | 2068548585 |
Mailing Telephone | 2068548585 |
Enumeration Date | 2016-01-20 |
Last Update Date | 2016-01-20 |
Authorized Official Name | DR. AMBRE ANN KRAGOR (ORTHODONTIST) |
Authorized Official Telephone | 2068548585 |
Authorized Official Credential | DDS, MS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
DN014936 | GA | Dental Providers |
Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
DN014935 | GA | Dental Providers |
Street Address |
1816 EAGLE DR SUITE 100-B |
City | WOODSTOCK |
State | GA |
Zip Code | 30189-8272 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013997139 | Ross Joseph Brakeville | Physical Therapist | 1816 Eagle Dr, Building 100, Suite C, Woodstock, GA 30189-8272 | 2006-01-17 |
1336420017 | Robert Riesing | Physical Therapist | 1816 Eagle Dr, Suite C, Woodstock, GA 30189-8272 | 2011-09-08 |
1346540432 | Park Pediatric Dentistry of Woodstock, LLC | Dentist | 1816 Eagle Dr, Suite 200-c, Woodstock, GA 30189-8272 | 2010-10-24 |
1750514295 | Eagle Drive Family Medicine PC | General Practice | 1816 Eagle Dr, Suite 200-b, Woodstock, GA 30189-8272 | 2009-09-01 |
1710022942 | Julius Park | Dentist | 1816 Eagle Dr, 200-c, Woodstock, GA 30189-8272 | 2007-02-21 |
1972659332 | Pt Solutions of Acworth, LLC | Physical Therapist | 1816 Eagle Dr, Building 100, Suite C, Woodstock, GA 30189-8272 | 2007-01-26 |
1538210695 | Scott Harden | Dentist | 1816 Eagle Dr, Bldg 200 Ste A, Woodstock, GA 30189-8272 | 2007-01-16 |
1548299332 | Richard Leon Manrique | Emergency Medicine | 1816 Eagle Dr, Suite 200-b, Woodstock, GA 30189-8272 | 2006-07-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801494356 | Susan Iruku | Pharmacist | 12050 Ga-92 #112, Woodstock, GA 30189 | 2020-10-15 |
1598267437 | Kelly Sierra | Nurse Practitioner | 100 Stoneforest Dr Ste 300, Woodstock, GA 30189 | 2018-03-07 |
1548770449 | Chandra Johnson | Nurse Practitioner | 295 Molly Lane Ste 150, Woodstock, GA 30189 | 2017-10-05 |
1083133912 | Amanda Bostock Sowisdral | Physician Assistant | 250 Parkbrooke Pl Ste 300, Woodstock, GA 30189 | 2017-09-12 |
1780101659 | Laura C Koch Woodstock LLC Dba Fountain View Dentistry | Dentist | 1816 Eagle Drive, Building 200-a, Woodstock, GA 30189 | 2017-08-23 |
1265954788 | Vicky Morton Bryan | Nurse Practitioner | 422 Sycamore Trail, Woodstock, GA 30189 | 2017-07-17 |
1063933588 | Marietta Eye Clinic, Pa | Optometrist | 2990 Eagle Dr Ste 110, Woodstock, GA 30189 | 2017-07-06 |
1275914749 | Nrup Tolat | Podiatrist | 100 Stoneforest Dr Ste 120, Woodstock, GA 30189 | 2015-06-10 |
1558781534 | Mary Jansson Carmon | Nurse Practitioner | 1000 Towne Lake Pkwy, Woodstock, GA 30189 | 2014-04-17 |
1518388941 | Afc Physicians of Georgia, PC | General Practice | 6440 Bells Ferry Rd, Woodstock, GA 30189 | 2014-01-03 |
Find all providers in zip 30189 |
Taxonomy Code | 1223X0400X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Orthodontics and Dentofacial Orthopedics |
That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982916755 | Jeffrey Michael Segnere | Dentist | 2054 Eagle Dr, Suite 120, Woodstock, GA 30189-6994 | 2010-07-09 |
1447375654 | Michael D'armond Williams | Dentist | 145 Towne Lake Pkwy, Suite 201, Woodstock, GA 30188-4847 | 2007-03-20 |
1710997002 | Kirk H Christensen | Dentist | 226 W Judd St, Woodstock, IL 60098-3158 | 2006-08-09 |
1326340407 | John Iaculli | Dentist | 2230 Towne Lake Pkwy, Building 1100, Ste 100, Woodstock, GA 30189-5540 | 2010-11-23 |
1326349945 | Family Orthodontics of Ws, LLC | Dentist | 2230 Towne Lake Pkwy, Building 1100, Ste 100, Woodstock, GA 30189-5540 | 2010-11-12 |
1992990873 | Dustin Shane Tipton | Dentist | 2230 Towne Lake Pkwy, Bldg 1100 Suite 100, Woodstock, GA 30189 | 2007-09-13 |
1407061286 | J. Jeff Kincaid, Dmd, Ms | Dentist | 355 Parkway 575, Suite 200, Woodstock, GA 30188-3882 | 2007-05-14 |
1083834063 | Kevin T Spillane | Dentist | 335 Parkway 575, Suite 200, Woodstock, GA 30188-6433 | 2007-05-01 |
1730215492 | Joseph Jeffrey Kincaid | Dentist | 355 Parkway 575, Suite 200, Woodstock, GA 30188-3882 | 2007-02-26 |
1518035849 | Andrew Dean Chen | Dentist | 12195 Highway 92, Suite 148, Woodstock, GA 30188-3602 | 2006-12-04 |
Find all providers in WOODSTOCK |
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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.