NORTHEAST GEORGIA DENTAL PROFESSIONALS, LLC (NPI# 1093283715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093283715 |
| Entity Type | Organization |
| Organization Name | NORTHEAST GEORGIA DENTAL PROFESSIONALS, LLC |
| Practice Address |
2700 Braselton Hwy Ste 12 Dacula GA 30019-3263 |
| Practice Telephone | 7709324240 |
| Mailing Telephone | 7709324240 |
| Enumeration Date | 2018-11-12 |
| Last Update Date | 2018-11-12 |
| Authorized Official Name | ERIC JONES (CEO) |
| Authorized Official Telephone | 7709324240 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Advanced & Family Dentistry | Doing Business As Name - Organization |
| Street Address |
2700 BRASELTON HWY STE 12 |
| City | DACULA |
| State | GA |
| Zip Code | 30019-3263 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780228171 | Mackenson Lafortune | Physical Therapy Assistant | 1424 Filigree Pl, Dacula, GA 30019 | 2019-10-29 |
| 1780167452 | Adenike Alaga | Registered Nurse | 3196 Dolostone Way, Dacula, GA 30019 | 2018-09-10 |
| 1780160580 | Cielitha Ruffin | Nurse Practitioner | 1223 Bentley Estates Dr., Dacula, GA 30019 | 2018-07-15 |
| 1386135663 | Anke Mbapeh | Nurse Practitioner | 2100 Browning Bend Ct, Dacula, GA 30019 | 2018-05-23 |
| 1053820282 | Ethan Zachariah Merrow | Student in an Organized Health Care Education/Training Program | 1701 Mulberry Lake Drive, Dacula, GA 30019 | 2017-09-20 |
| 1043737547 | Dawn Hedley | Dietitian, Registered | 3567 Vern Way, Dacula, GA 30019 | 2017-08-25 |
| 1831545367 | Angela Owusu-edusei | Nurse Practitioner | 3226 Dolostone Way, Dacula, GA 30019 | 2016-05-13 |
| 1528458718 | Philomena Gyamfi | Registered Nurse | 1088 Milford Ln, Dacula, GA 30019 | 2015-01-27 |
| 1417375247 | Casey Goldman Sommerfeld | Pediatrics | 2240 Hamilton Creek Pkwy Ste 600, Dacula, GA 30019 | 2014-03-29 |
| 1417398215 | Samia Tahil | Home Health | 2821 Spence Ct, Dacula, GA 30019 | 2013-07-10 |
| Find all providers in zip 30019 | ||||
| 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 |
|---|---|---|---|---|
| 1326577420 | Ebad Habeeb | Dentist | 3611 Braselton Hwy Ste 104, Dacula, GA 30019-4672 | 2017-06-12 |
| 1013388552 | Georgia Dental Professionals, PC | Dentist | 635 Dacula Rd, Suite 105, Dacula, GA 30019-2102 | 2015-10-09 |
| 1285040527 | Uyen Do Maschek | Dentist | 2055 Hamilton Creek Pkwy Ste 140, Dacula, GA 30019-7205 | 2014-07-08 |
| 1689938862 | Tebo Dentistry for Kids Dacula, LLC | Dentist | 1152 Auburn Rd, Building 1, Suite 101, Dacula, GA 30019-5444 | 2012-07-02 |
| 1053622712 | David George Quintero | Dentist | 2098 Teron Trce Ste 600, Dacula, GA 30019-1664 | 2010-06-28 |
| 1215193545 | Linda Marie Stringer | Dentist | 1750 Luke Edwards Rd, Dacula, GA 30019-2524 | 2008-08-06 |
| 1881721991 | Carey L. Norton, D.m.d., P.C. | Dentist | 100 Dacula Rd, Dacula, GA 30019-2134 | 2007-02-27 |
| 1144304833 | Brittany N Meyer | Dentist | 3611 Braselton Hwy, Suite 104, Dacula, GA 30019-4671 | 2006-10-25 |
| 1285720144 | Wenona B Van Derhei | Dentist | 3590 Braselton Hwy Ste 103, Dacula, GA 30019-1120 | 2006-10-05 |
| 1740251073 | Van Derhei Implant Prosthetics Dental LLC | Dentist | 3625 Braselton Hwy, #102, Dacula, GA 30019 | 2006-01-26 |
| Find all providers in DACULA | ||||
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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.