DR. THEODIS ELZIE (NPI# 1164440095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164440095 |
| Entity Type | Individual |
| Full Name | DR. THEODIS ELZIE |
| Credential | D.D.S. |
| Practice Address |
705 Windy Hill Rd Se Smyrna GA 30080-1854 |
| Practice Telephone | 7708011641 |
| Practice Fax Number | 7708010587 |
| Mailing Telephone | 7708011641 |
| Mailing Fax Number | 7708010587 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 010679 | GA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00867908A | 05 |
| Street Address |
705 WINDY HILL RD SE |
| City | SMYRNA |
| State | GA |
| Zip Code | 30080-1854 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780993840 | Theodis Elzie, D.d.s., P.C. | Dentist | 705 Windy Hill Rd Se, Smyrna, GA 30080-1854 | 2010-10-06 |
| 1386855880 | Keith E Shepard | Dentist | 705 Windy Hill Rd Se, Smyrna, GA 30080-1854 | 2007-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881205169 | Suny Varughese | Nurse Practitioner | Minute Clinic, 2994 Atlanta Rd, Se, Smyrna, GA 30080 | 2020-08-11 |
| 1891287645 | Provident Group - Creekside Properties LLC | Alzheimer Center (Dementia Center) | 4838 South Cobb Drive, Smyrna, GA 30080 | 2018-06-06 |
| 1710490743 | Alina Rim | Registered Nurse | 4532 Chelton Ct Se, Smyrna, GA 30080 | 2017-11-13 |
| 1932626488 | Richard Kyle Davis | Pharmacist | 2955 Atlanta Rd Se, Smyrna, GA 30080 | 2017-08-25 |
| 1982071163 | Amelia Rafaela Turrubiates-huacuja | Counselor | 1246-c Concord Rd, Suite 101, Smyrna, GA 30080 | 2015-08-24 |
| 1275919755 | Anne Waldner Rohling | Physical Therapist | 1155 Concord Rd Se Ste 210, Smyrna, GA 30080 | 2015-08-06 |
| 1790167856 | Kay Yetunde Johnson | Nurse Practitioner | 3001 Lusk Dr, Smyrna, GA 30080 | 2015-06-25 |
| 1689055436 | Anew You Couneling, LLC | Community/Behavioral Health | 3188 Atlanta Rd, Smyrna, GA 30080 | 2015-06-17 |
| 1457766370 | Trondi Jerry | Counselor | 3381 Atlanta Rd Se, Smyrna, GA 30080 | 2014-06-30 |
| 1093081903 | Ashish Kapila | Podiatrist | Wellstar Podiatry, 4441 Atlanta Rd Se Suite 215, Smyrna, GA 30080 | 2012-03-25 |
| Find all providers in zip 30080 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962917575 | Jared Wilson Bristol | Dentist | 573 Concord Rd Se Ste C, Smyrna, GA 30082-2611 | 2017-12-05 |
| 1174052245 | Stacey Elise Reich | Dentist | 4849 S Cobb Dr Se Ste 111, Smyrna, GA 30080-7145 | 2017-06-12 |
| 1114464062 | Signature Smiles Family Dentistry | Dentist | 1932 Almaville Rd, Suite 105, Smyrna, TN 37167-4404 | 2017-01-30 |
| 1669840211 | Smyrna Modern Dentistry, PC | Dentist | 160 Movie Row, Smyrna, TN 37167 | 2015-09-11 |
| 1205210911 | Richard Anderson | Dentist | 840 Nissan Dr., Smyrna, TN 37167 | 2015-07-13 |
| 1003305251 | Hannah Isabel Alexander | Dentist | 4500 W Village Pl Se Unit 2015, Smyrna, GA 30080-9245 | 2013-08-24 |
| 1407102015 | Daniel C. Norris | Dentist | 620 Concord Rd Se, Smyrna, GA 30082-2619 | 2012-08-01 |
| 1801184478 | Sara Twardy | Dentist | 1060 Windy Hill Road Se, Suite 220, Smyrna, GA 30080 | 2011-07-18 |
| 1184920985 | Integrity Dental Care, Pllc | Dentist | 301 Wolverine Trl Ste 203, Smyrna, TN 37167-5656 | 2011-01-27 |
| 1962716472 | Cheryl R Coggins | Dentist | 440 Sam Ridley Pkwy W Ste 140, Smyrna, TN 37167-2999 | 2010-07-27 |
| Find all providers in SMYRNA | ||||
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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.