DR. ABTIN ETEZADI-TABRIZI (NPI# 1366601866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366601866 |
| Entity Type | Individual |
| Full Name | DR. ABTIN ETEZADI-TABRIZI |
| Credential | DMD |
| Practice Address |
1000 Johnson Ferry Rd Bldg H Marietta GA 30068 |
| Mailing Address |
1120 15th Street- Medical College of Georgia School of Dentistry Augusta GA 30912 |
| Practice Telephone | 7709770364 |
| Practice Fax Number | 6784838487 |
| Mailing Telephone | 7067212411 |
| Mailing Fax Number | 7067210997 |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2018-09-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DN013742 | GA | Dental Providers |
| Street Address |
1000 JOHNSON FERRY RD BLDG H |
| City | MARIETTA |
| State | GA |
| Zip Code | 30068 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104819101 | John Paul Labanc | Dentist | 1000 Johnson Ferry Rd Bldg H, Marietta, GA 30068 | 2005-08-24 |
| 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 |
| 1912165721 | Henry Kime Blair | Dentist | 1000 Johnson Ferry Rd Bldg H, Marietta, GA 30068-5518 | 2008-05-29 |
| 1194881532 | Joseph William Slaughter | Dentist | 1000 Johnson Ferry Rd Bldg H, Marietta, GA 30068 | 2006-12-29 |
| 1093881021 | Jonathan Maxwell Chrisenberry Threadgill | Dentist | 1000 Johnson Ferry Rd Bldg H, Marietta, GA 30068-5518 | 2006-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831798917 | Barbara Ann Goldschmidt | Pharmacist | 4088 Lower Roswell Rd, Marietta, GA 30068 | 2020-10-20 |
| 1285274480 | Cory Plasker | Chiropractor | 519b Johnson Ferry Road, Suite 350, Marietta, GA 30068 | 2020-01-15 |
| 1952949893 | Dr Amy L Varner LLC | Internal Medicine | 1000 Johnson Ferry Rd Bldg E Ste 200, Marietta, GA 30068 | 2019-12-11 |
| 1417501834 | Cornerstone Hospice and Palliative Care of Georgia, LLC | Hospice Care, Community Based | 1225 Johnson Ferry Rd., Bldg. 100, Suite 160, Marietta, GA 30068 | 2019-07-25 |
| 1639721038 | Cayla Clark | Behavior Technician | 137 Johnson Ferry Road Suite 2170, Marietta, GA 30068 | 2019-07-15 |
| 1467910828 | 2me Healthcare,llc | Home Health | 2586 Club Valley Drive Ne, Marietta, GA 30068 | 2019-03-05 |
| 1265912604 | Feidy Chiropractic Clinic Inc, Dba Cardwell Chiropractic Clinic | Chiropractor | 1230 Johnson Ferry Pl Ste G30, Marietta, GA 30068 | 2018-08-15 |
| 1225514219 | Audrey Hughes. Lcsw, LLC | Clinic/Center | 1212 Johnson Ferry Rd, Suite 300, Marietta, GA 30068 | 2018-07-13 |
| 1316461379 | Evan King | Registered Nurse | 52 Pioneer Trl, Marietta, GA 30068 | 2017-08-01 |
| 1912431867 | Anthony Izore | Nurse Practitioner | 5163 Tall Oak Drive, Marietta, GA 30068 | 2017-04-18 |
| Find all providers in zip 30068 | ||||
| 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 |
| 1104172741 | Mountain View Oral Surgery & Dental Implants LLC | Dentist | 121 Marble Mill Rd Nw, Suite 202, Marietta, GA 30060-7959 | 2012-08-01 |
| 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 |
| 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.