MUCCIOLI DENTAL, PC (NPI# 1558796896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558796896 |
| Entity Type | Organization |
| Organization Name | MUCCIOLI DENTAL, PC |
| Practice Address |
6300 Hospital Pkwy Suite 275 Johns Creek GA 30097-1828 |
| Practice Telephone | 6783899955 |
| Practice Fax Number | 6783899952 |
| Mailing Telephone | 6783899955 |
| Mailing Fax Number | 6783899952 |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2013-09-05 |
| Authorized Official Name | DR. RANDY EARL MUCCIOLI (OWNER/DENTIST) |
| Authorized Official Telephone | 6783899955 |
| Authorized Official Credential | D.M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0700X |
Dentist Specialization: Prosthodontics |
DN014379 | GA | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DN014378 | GA | Dental Providers |
| Street Address |
6300 HOSPITAL PKWY SUITE 275 |
| City | JOHNS CREEK |
| State | GA |
| Zip Code | 30097-1828 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164422572 | William Jay Lichtenfeld | Physical Medicine & Rehabilitation | 6300 Hospital Pkwy, Suite 400, Johns Creek, GA 30097-1828 | 2005-07-28 |
| 1801320510 | Johns Creek Center for Pain and Spine | Clinic/Center | 6300 Hospital Pkwy, Suite 425, Johns Creek, GA 30097-1828 | 2017-04-19 |
| 1922547538 | Andre Bell Sr. | Physical Therapist | 6300 Hospital Pkwy, Suite 400, Johns Creek, GA 30097-1828 | 2017-02-15 |
| 1831577568 | Orthoatlanta | Specialist | 6300 Hospital Pkwy, Johns Creek, GA 30097-1828 | 2015-05-14 |
| 1174918411 | Heather Deberry | Physician Assistant | 6300 Hospital Pkwy, Suite 400, Johns Creek, GA 30097-1828 | 2015-04-03 |
| 1447665757 | Dorkesha Marvena Denise Hill | Specialist/Technologist | 6300 Hospital Pkwy, Suite 400, Johns Creek, GA 30097-1828 | 2014-06-25 |
| 1558787614 | Digestive Care Endoscopy | Clinic/Center | 6300 Hospital Pkwy, Ste 440, Johns Creek, GA 30097-1828 | 2014-03-13 |
| 1417295528 | Atlanta General and Bariatric Surgery Center, LLC | Clinic/Center | 6300 Hospital Pkwy, Suite 150, Johns Creek, GA 30097-1828 | 2013-01-24 |
| 1477804540 | Nsh Cancer Institute Professional Services G LLC | Durable Medical Equipment & Medical Supplies | 6300 Hospital Pkwy, Suite 300, Johns Creek, GA 30097-1828 | 2012-09-28 |
| 1003112970 | Digestive Care Physicians, LLC | Specialist | 6300 Hospital Pkwy, Suite 450, Johns Creek, GA 30097-1828 | 2011-02-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659986057 | Herman Medical Solutions, LLC | Internal Medicine | 10700 Medlock Bridge Road, Suite 207, Duluth, GA 30097 | 2020-09-11 |
| 1649808619 | Kirsty Amber Ramirez | Behavior Technician | 218 Premiere Pkwy #500, Duluth, GA 30097 | 2020-03-27 |
| 1386277820 | Cristina Madalina Niculas | Pharmacist | Kroger Pharmacy 476, 6555 Sugarloaf Parkway, Duluth, GA 30097 | 2020-02-12 |
| 1619514924 | Opesdei Health Solutions | Home Health Aide | 6615 Abbotts Bridge Road, 6615 Abbotts Bridge Road Unit 1111, Johns Creek, GA 30097 | 2019-12-05 |
| 1700422979 | Ria Alexander | Nurse Practitioner | 6300 Hospital Parkway Ste 300, Johns Creek, GA 30097 | 2019-11-22 |
| 1043867765 | Mosesal Zakia White | Nurse Practitioner | 10680 Medlock Bridge Rd #102, Johns Creek, GA 30097 | 2019-08-19 |
| 1982187068 | Lighthouse Clinical Counseling, LLC | Counselor | 3883 Rogers Bridge Road, Suite 601, Duluth, GA 30097 | 2018-09-13 |
| 1376025643 | Faithe Beanne Kimsey | Counselor | 3883 Rogers Bridge Road Nw, Suite 601, Duluth, GA 30097 | 2018-09-04 |
| 1306330303 | Denise Jackson | Prosthetist | 11720 Medlock Bridge Rd Ste 155, Johns Creek, GA 30097 | 2018-06-21 |
| 1407363328 | Berkeley Van Dyke | Physical Therapist | 6335 Hospital Pkwy Ste 316, Johns Creek, GA 30097 | 2017-12-30 |
| Find all providers in zip 30097 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528611050 | Jaime Cheung | Dentist | 4940 Agate Dr, Johns Creek, GA 30022-7367 | 2019-07-23 |
| 1205341435 | Moosa Dalwai | Dentist | 450 Darrow Dr, Johns Creek, GA 30097-2430 | 2017-12-11 |
| 1013201904 | Daniel Woohyun Cho | Dentist | 10505 Stonepoint Pl, Johns Creek, GA 30097-5955 | 2011-06-08 |
| 1710012943 | Alim Jamal Grant Sr. | Dentist | 3280 Old Alabama Rd, Suite 200, Johns Creek, GA 30022-8544 | 2007-02-21 |
| 1831240605 | Brian John Dowd | Dentist | 9775 Medlock Bridge Road, Johns Creek, GA 30097 | 2007-01-16 |
| 1477656825 | James G Forester | Dentist | 9590 Medlock Bridge Road, Suite F, Johns Creek, GA 30097-5987 | 2006-09-07 |
| 1871607309 | Frank William Maybusher | Dentist | 395 Cadeleigh Ct, Johns Creek, GA 30005-8925 | 2006-08-19 |
| 1164029757 | Georgia Dental Professionals, PC | Dentist | 9925 Haynes Bridge Rd, Johns Creek, GA 30022-8532 | 2020-10-06 |
| 1215576160 | Georgia Dental Professionals, PC | Dentist | 2880 Old Alabama Rd, Johns Creek, GA 30022-5031 | 2019-12-24 |
| 1073979837 | H&b Family Dental, LLC | Dentist | 10360 Medlock Bridge Rd, Suite D, Johns Creek, GA 30097-5927 | 2016-01-10 |
| Find all providers in JOHNS CREEK | ||||
| City | JOHNS CREEK |
| Zip Code | 30097 |
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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.