NORTHWEST ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, P.C. (NPI# 1194732735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194732735 |
| Entity Type | Organization |
| Organization Name | NORTHWEST ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, P.C. |
| Practice Address |
55 Whitcher St Ne Suite 140 Marietta GA 30060-1155 |
| Practice Telephone | 7704227630 |
| Practice Fax Number | 7704226017 |
| Mailing Telephone | 7704227630 |
| Mailing Fax Number | 7704226017 |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2015-06-22 |
| Authorized Official Name | MANUEL A. DAVILA (PRESIDENT) |
| Authorized Official Telephone | 7704227630 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| Street Address |
55 WHITCHER ST NE SUITE 140 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-1155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730183377 | Vijay Nath | Specialist | 55 Whitcher St Ne, Ste 460, Marietta, GA 30060-1171 | 2005-06-10 |
| 1710452875 | Jaleny Abajobir | Nurse Practitioner | 55 Whitcher St Ne, Marietta, GA 30060-1155 | 2018-10-04 |
| 1366961591 | Rachel Alexandra Strickland | Nurse Practitioner | 55 Whitcher St Ne, Marietta, GA 30060-1155 | 2017-09-19 |
| 1730609850 | Rudi Maria Coleman | Social Worker | 55 Whitcher St Ne, Marietta, GA 30060-1155 | 2017-06-20 |
| 1114451432 | Nerma S Mccrary | Nurse Practitioner | 55 Whitcher St Ne, Suite 460, Marietta, GA 30060-1155 | 2017-04-13 |
| 1215476304 | G | Nurse Practitioner | 55 Whitcher St Ne, Marietta, GA 30060-1155 | 2017-02-22 |
| 1972042117 | Joslyn Gross | Nurse Practitioner | 55 Whitcher St Ne, Ste 160, Marietta, GA 30060-1155 | 2017-02-21 |
| 1639616089 | Lonnie Jones | Nurse Practitioner | 55 Whitcher St Ne, Suite 130, Marietta, GA 30060-1155 | 2017-01-24 |
| 1073059804 | Melida Garcia | Nurse Practitioner | 55 Whitcher St Ne, Suite 350, Marietta, GA 30060-1155 | 2017-01-18 |
| 1528503166 | Helen W. James | Nurse Practitioner | 55 Whitcher St Ne, Suite 350, Marietta, GA 30060-1155 | 2017-01-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1407477193 | Michael Cynil Daniel | Counselor | 698 N Marietta, Pkwy, Marietta, GA 30060 | 2020-05-04 |
| 1285253401 | Cameron Thomas Kennelly | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne Attn:gme, Marietta, GA 30060 | 2020-04-09 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1164064945 | Denise Alicia Mick | Registered Nurse | 677 Church St Wellstar Kennestone Hospital, Marietta, GA 30060 | 2019-10-12 |
| 1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
| 1346703212 | Caitlin Virginia Mueller | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 | 2019-04-08 |
| 1184187205 | Adero Francis | Student in an Organized Health Care Education/Training Program | Wellstar Kennestone Gme Internal Medicine Clinic, 833 Campbell Hill St Nw, Suite 250, Marietta, GA 30060 | 2019-04-08 |
| 1659832749 | Matthew Mozzo | Student in an Organized Health Care Education/Training Program | 677 Church Street / Lower Level, Gme Department / I.m., Marietta, GA 30060 | 2019-03-29 |
| 1245797430 | La'myia Spentz | Specialist | 109 Anderson St Ne, Suite 608, Marietta, GA 30060 | 2019-02-25 |
| Find all providers in zip 30060 | ||||
| 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.