SAGE DENTAL GROUP OF GEORGIA LLC (NPI# 1417481599) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417481599 |
| Entity Type | Organization |
| Organization Name | SAGE DENTAL GROUP OF GEORGIA LLC |
| Other Organization Name | SAGE DENTAL OF MARIETTA |
| Practice Address |
1050 E Piedmont Rd Suite 114-118 Marietta GA 30062-4758 |
| Practice Telephone | 6787654665 |
| Practice Fax Number | 5614318169 |
| Mailing Telephone | 6785404665 |
| Mailing Fax Number | 5614318169 |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2018-02-20 |
| Authorized Official Name | JONATHAN CHANG (CHIEF DENTAL DIRECTOR) |
| Authorized Official Telephone | 5619999650 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| Other Name | Type Code |
|---|---|
| Sage Dental of Marietta | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710416466 | Sage Dental Group of Georgia LLC | Dentist | 1 Baltimore Pl Nw Ste 403, Atlanta, GA 30308-2116 | 2017-06-07 |
| 1164956157 | Sage Dental Group of Georgia LLC | Dentist | 4320 Lavista Rd, Suite C119, Tucker, GA 30084 | 2017-04-17 |
| 1194260679 | Sage Dental Group of Georgia LLC | Dentist | 4811 Lower Roswell Rd, Suite 108, Marietta, GA 30068-4372 | 2016-12-20 |
| 1295276061 | Sage Dental Group of Georgia LLC | Dentist | 876 Buford Rd, Cumming, GA 30041-2716 | 2017-03-14 |
| Street Address |
1050 E PIEDMONT RD SUITE 114-118 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30062-4758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518906577 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 1050 E Piedmont Rd, Marietta, GA 30062-4758 | 2006-06-05 |
| 1598312472 | Lidia Girma | Pharmacist | 1050 E Piedmont Rd, Marietta, GA 30062-4758 | 2019-08-24 |
| 1447627104 | Kingsley Onokalah | Pharmacist | 1050 E Piedmont Rd, Suite P, Marietta, GA 30062-4758 | 2015-08-28 |
| 1245638998 | Atlanta Laser Vein Institute, LLC | Surgery | 1050 E Piedmont Rd, Suite 104, Marietta, GA 30062-4758 | 2014-12-11 |
| 1609283316 | Trent Leonard | Pharmacist | 1050 E Piedmont Rd, Suite #130 - Publix Pharmacy, Marietta, GA 30062-4758 | 2014-07-14 |
| 1295073260 | Kimberly Addy | Pharmacist | 1050 E Piedmont Rd, Marietta, GA 30062-4758 | 2013-01-24 |
| 1306183231 | Christine K Walker | Pharmacist | 1050 E Piedmont Rd, Marietta, GA 30062-4758 | 2013-01-11 |
| 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 | 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 |
|---|---|---|---|---|
| 1538714639 | Dionne Joi Wells | Dentist | 3805 Dallas Hwy Sw Ste 806, Marietta, GA 30064-1620 | 2019-08-06 |
| 1346736931 | Graham A Kellams | Dentist | 2655 Dallas Hwy Sw Ste 510, Marietta, GA 30064-7520 | 2018-07-06 |
| 1972090504 | Waldron and Lee Dentistry LLC | Dentist | 3020 Roswell Rd Ste 100, Marietta, GA 30062-4987 | 2018-04-19 |
| 1245750165 | Paul Douglas Martin | Dentist | 270 Cobb Pkwy S Ste 180, Marietta, GA 30060-6520 | 2017-06-21 |
| 1700310893 | West Cobb Dentist Office, PC | Dentist | 3805 Dallas Hwy Sw, Suite 804, Marietta, GA 30064 | 2017-04-14 |
| 1225577737 | Holly Markwordt | Dentist | 1136 Taliwa Trl Ne, Marietta, GA 30068-2389 | 2017-02-16 |
| 1578000444 | Engineered Smiles, LLC | Dentist | 670 Johnson Ferry Rd, Marietta, GA 30068-4627 | 2017-01-30 |
| 1194260679 | Sage Dental Group of Georgia LLC | Dentist | 4811 Lower Roswell Rd, Suite 108, Marietta, GA 30068-4372 | 2016-12-20 |
| 1396103537 | Hira Rana | Dentist | 1721 Powder Springs Rd Sw, Suite 103, Marietta, GA 30064-4879 | 2016-02-02 |
| 1437535325 | Daniel Van Galder | Dentist | 361 N Marietta Pkwy Ne, Marietta, GA 30060-1545 | 2015-08-03 |
| 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.