DR. HUSAM MOHAMAD BEZREH (NPI# 1245257898) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245257898 |
| Entity Type | Individual |
| Full Name | DR. HUSAM MOHAMAD BEZREH |
| Other Name | MOHAMAD HUSAM ALBZREH |
| Credential | DMD |
| Practice Address |
1505 Johnson Ferry Road Suite 100 Marietta GA 30062-6508 |
| Mailing Address |
1505 Johnson Ferry Road Suite 100 Marietta GA 30062 |
| Practice Telephone | 7709739765 |
| Practice Fax Number | 7709739783 |
| Mailing Telephone | 7709739765 |
| Mailing Fax Number | 7709739783 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2015-01-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
DN013014 | GA | Dental Providers |
| Street Address |
1505 JOHNSON FERRY ROAD SUITE 100 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30062-6508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578051 | Pamela D Kretzmer | Social Worker | 3855 Shallowford Road, Suite 420, Marietta, GA 30062 | 2020-11-03 |
| 1932714680 | Michelle Chambless | Physical Therapist | Team Rehabilitation Ga01, LLC, 1401 Johnson Ferry Road, Suite 340, Marietta, GA 30062 | 2020-09-10 |
| 1700408887 | Life University | Chiropractor | 1323 Roswell Road, Marietta, GA 30062 | 2020-05-12 |
| 1104451160 | Sno Healthcare Group | Clinic/Center | 2424 Roswell Rd Ste 120, Marietta, GA 30062 | 2020-03-10 |
| 1811536212 | Sandy Plains Dental Group, PC | Dentist | 3460 Sandy Plains Rd, Suite 240, Marietta, GA 30062 | 2020-01-02 |
| 1073159034 | Magdala Tulcie Jodesty-jackson | Social Worker | 4343 Shalloword Road, Building H, Suite 4 Lower Level, Marietta, GA 30062 | 2019-11-25 |
| 1598235178 | Matthew Driggers | Counselor | 4343 Shallowford Rd C2, Marietta, GA 30062 | 2018-11-27 |
| 1750895785 | Emily Grace Minday | Counselor | 4343 Shallowford Road Building C, Suite 1 Lower Level, Marietta, GA 30062 | 2017-11-29 |
| 1477072122 | Jason Lee Amos | Speech-Language Pathologist | 3660 Chestnut Ridge Court, Marietta, GA 30062 | 2017-09-13 |
| 1346761376 | Marian Pomaah Opoku-agyeman | Nurse Practitioner | 4661 Andrea Pointe, Marietta, GA 30062 | 2017-06-29 |
| Find all providers in zip 30062 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912157355 | Ranjitha Krishna | Dentist | 810 Canton Rd Ne Ste B, Marietta, GA 30060-7257 | 2008-09-23 |
| 1952523623 | Wilkie J Stadeker | Dentist | 123 Marble Mill Rd Nw, Suite B, Marietta, GA 30060-7954 | 2007-05-03 |
| 1992847610 | Susan Alexander, Dmd, PC | Dentist | 3020 Roswell Rd Ste 130, Marietta, GA 30062-4987 | 2007-02-12 |
| 1982798716 | Peter Clifford Shatz | Dentist | 611 Campbell Hill St Nw, Suite 102, Marietta, GA 30060-1386 | 2006-10-03 |
| 1477574994 | Drs. Silver and Tomaselli, P.C. | Dentist | 810 Canton Rd Ne, Suite B, Marietta, GA 30060-7257 | 2006-07-21 |
| 1316243389 | Kennestone Periodontics of Marietta, PC | Dentist | 611 Campbell Hill St Nw, Suite 102, Marietta, GA 30060-1386 | 2011-02-08 |
| 1104084235 | Susan Patricia Alexander | Dentist | 3020 Roswell Rd Ste 130, Marietta, GA 30062-4987 | 2008-05-27 |
| 1265553614 | Martin Silver | Dentist | 810 Canton Rd Ne, Suite B, Marietta, GA 30060-7257 | 2007-04-03 |
| 1801942347 | Larry Sweeting | Dentist | 1275 Powers Ferry Rd Se, Marietta, GA 30067-9486 | 2007-01-26 |
| 1346312071 | William B. Webster, Jr., Dds, PC | Dentist | 1225 Johnson Ferry Rd, Suite 760, Marietta, GA 30068-2727 | 2006-11-15 |
| 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.