NORTHEAST GEORGIA DENTAL GROUP (NPI# 1013121359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013121359 |
| Entity Type | Organization |
| Organization Name | NORTHEAST GEORGIA DENTAL GROUP |
| Practice Address |
1200 Sherwood Park Dr Ne Gainesville GA 30501-3445 |
| Practice Telephone | 7705324555 |
| Mailing Telephone | 7705324555 |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2011-10-19 |
| Authorized Official Name | DR. RICHARD G. BENNETT (OWNER) |
| Authorized Official Telephone | 7705324555 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DN011850 | GA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063904076 | Northeast Georgia Dental Group | Dentist | 1205 Friendship Road, Braselton, GA 30517 | 2018-06-05 |
| Street Address |
1200 SHERWOOD PARK DR NE |
| City | GAINESVILLE |
| State | GA |
| Zip Code | 30501-3445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306958467 | Richard G Bennett Jr. | Dentist | 1200 Sherwood Park Dr Ne, Gainesville, GA 30501 | 2006-08-31 |
| 1295367472 | Dental Now 14 | Clinic/Center | 1200 Sherwood Park Dr Ne, Gainesville, GA 30501-3445 | 2020-02-06 |
| 1235578923 | Matthew Lawrence Vaughn | Dentist | 1200 Sherwood Park Dr Ne, Gainesville, GA 30501-3445 | 2013-06-17 |
| 1598979981 | Cynthia Fulenwider Greene | Dentist | 1200 Sherwood Park Dr Ne, Gainesville, GA 30501-3445 | 2007-05-09 |
| 1093899122 | Ryan Wood | Dentist | 1200 Sherwood Park Dr Ne, Gainesville, GA 30501-3445 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437782851 | Madison Raye Huth | Physician Assistant | 743 Spring Street Se, Gainesville, GA 30501 | 2020-02-13 |
| 1205487659 | Grace M Walker Brown | Nurse Practitioner | 592 Medical Park Dr., Suite A, Gainesville, GA 30501 | 2019-09-26 |
| 1174086987 | Nayab Ahmed | Student in an Organized Health Care Education/Training Program | 743 Spring Street, Suite 710, Gainesville, GA 30501 | 2019-04-09 |
| 1154881118 | Ryan D Berry | Student in an Organized Health Care Education/Training Program | 734 Spring St Se Ste 710, Gainesville, GA 30501 | 2019-03-24 |
| 1609336304 | Harper E Niver | Student in an Organized Health Care Education/Training Program | 743 Spring St., Suite 710, Gainesville, GA 30501 | 2019-03-20 |
| 1508336173 | Bradee Burrell Aderholt | Nurse Practitioner | 663 Lanier Park Drive, Gainesville, GA 30501 | 2018-11-27 |
| 1578068359 | Soammy Liz Matias | Chiropractor | 961 Green Street, Gainesville, GA 30501 | 2018-03-26 |
| 1811496896 | Matthew Brown | Speech-Language Pathologist | 500 Spring St. Se Suite 101, Gainesville, GA 30501 | 2018-02-06 |
| 1346769825 | Dr. Skeete & Associates of North Georgia, P.C. | Optometrist | 150 Pearl Nix Parkway, Suite D3a, Gainesville, GA 30501 | 2017-09-15 |
| 1932624723 | M & B Imaging, PC | Radiology | 1640 Jesse Jewell Pkwy Se Ste 2, Gainesville, GA 30501 | 2017-08-14 |
| Find all providers in zip 30501 | ||||
| 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 |
|---|---|---|---|---|
| 1780293373 | Ariana Estefania Zeb | Dentist | 1230 Sw 11th Ave Apt C309, Gainesville, FL 32601-8255 | 2020-07-29 |
| 1609499151 | Prince William Dental LLC | Dentist | 7051 Heathcote Village Way Ste 100, Gainesville, VA 20155-3197 | 2020-05-19 |
| 1063059764 | Zara Zahid | Dentist | 1395 Center Dr # D11-6, Gainesville, FL 32610-3006 | 2019-12-02 |
| 1053972620 | Tasneem Koleilat | Dentist | 13718 Nw 30th Rd, Gainesville, FL 32606-9325 | 2019-06-25 |
| 1902387301 | Jennie Gabriele Ferrer | Dentist | 1395 Center Drive Ufcd, Dental Tower-second Floor- Office #d2-27, Gainesville, FL 32610-0415 | 2018-08-23 |
| 1508345695 | Carlos Kose Jr. | Dentist | 1395 Center Dr Rm D2-27, Gainesville, FL 32610-3006 | 2018-08-09 |
| 1639661010 | Luis E. Rodriguez Leyva | Dentist | 932 Nw 56th Ter, Gainesville, FL 32605-4480 | 2018-06-01 |
| 1215454830 | Whitney Kristine Schaff | Dentist | 6110 Nw 1st Pl, Gainesville, FL 32607 | 2017-08-24 |
| 1821443540 | Elizabeth A Hill, Dds, Pa | Dentist | 1000 Nw 8th Ave, Suite B, Gainesville, FL 32601-4986 | 2016-05-02 |
| 1477912319 | Ashleigh Michelle Weyh | Dentist | 1016 Sw 8th Ave 102, Gainesville, FL 32601-1334 | 2016-02-21 |
| Find all providers in GAINESVILLE | ||||
| City | GAINESVILLE |
| Zip Code | 30501 |
Please comment or provide details below to improve the information on NORTHEAST GEORGIA DENTAL GROUP.
| 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.