EMORY MEDICAL GROUP, LLC (NPI# 1568661510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568661510 |
| Entity Type | Organization |
| Organization Name | EMORY MEDICAL GROUP, LLC |
| Practice Address |
1365b Clifton Rd Ne Atlanta GA 30322-1013 |
| Mailing Address |
Po Box 116294 Atlanta GA 30368-6294 |
| Practice Telephone | 4047784500 |
| Practice Fax Number | 4047785879 |
| Mailing Telephone | 4047784500 |
| Mailing Fax Number | 4047785879 |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2007-07-11 |
| Authorized Official Name | MR. DONALD I BRUNN (COO) |
| Authorized Official Telephone | 4047784871 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
Ambulatory Health Care Facilities |
| Street Address |
1365B CLIFTON RD NE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30322-1013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235114547 | Beau Benjamin Bruce | Psychiatry & Neurology | 1365b Clifton Rd Ne, Suite B-3600, Atlanta, GA 30322-1013 | 2005-12-08 |
| 1235652918 | Jonathan Micieli | Ophthalmology | 1365b Clifton Rd Ne, Atlanta, GA 30322-1013 | 2017-07-25 |
| 1669902094 | Drake Robert Devos | Optometrist | 1365b Clifton Rd Ne, Atlanta, GA 30322 | 2017-06-18 |
| 1891227286 | Christian Mustroph | Student in an Organized Health Care Education/Training Program | 1365b Clifton Rd Ne, Room B6169c, Atlanta, GA 30322-3400 | 2017-04-03 |
| 1295189165 | Hosniya Zarabi | General Practice | 1365b Clifton Rd Ne, Room B6169c, Atlanta, GA 30322-1013 | 2016-04-18 |
| 1568825735 | Kc Biebighauser Bens | Student in an Organized Health Care Education/Training Program | 1365b Clifton Rd Ne, Suite 1400, Atlanta, GA 30322-1013 | 2016-04-04 |
| 1508229832 | Jean Park | Ophthalmology | 1365b Clifton Rd Ne, Atlanta, GA 30322-1013 | 2016-04-04 |
| 1649667866 | Andrew Erwood | Student in an Organized Health Care Education/Training Program | 1365b Clifton Rd Ne, Room B6169c, Atlanta, GA 30322-1013 | 2015-04-26 |
| 1346669827 | Jason Michael Frerich | Neurological Surgery | 1365b Clifton Rd Ne, Suite 6200, Atlanta, GA 30322-1013 | 2014-04-10 |
| 1144664673 | Charles Adam Lorentz | Urology | 1365b Clifton Rd Ne, Atlanta, GA 30322 | 2013-04-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700445830 | Justin Gill | Student in an Organized Health Care Education/Training Program | 1365 Clifton Rd Ne, Clinic B - Suite B6100, Atlanta, GA 30322 | 2019-06-12 |
| 1891354510 | Gwendolyn Gisiner Gunn | Genetic Counselor, MS | Emory Genetics Clinic, 1365 Clifton Road Ne, Atlanta, GA 30322 | 2019-06-06 |
| 1144710567 | Lisa Cathy-ann Akosa | Registered Nurse | 1365 Cifton Road Ne, Atlanta, GA 30322 | 2018-05-10 |
| 1083118004 | Jessica Milian Keilson | Student in an Organized Health Care Education/Training Program | 1364 Clifton Road Ne, Suite H100, Emory University Hospital Office of Surgical Education, Atlanta, GA 30322 | 2018-03-23 |
| 1568982684 | Jennifer Bilko | Dietitian, Registered | 1365 Clifton Rd., Bldg A, 1st Floor, Suite 1450, Atlanta, GA 30322 | 2017-06-20 |
| 1134652258 | Kassahun Bilcha | Student in an Organized Health Care Education/Training Program | 1525 Clifton Rd Ne Ste 100, Atlanta, GA 30322 | 2017-04-05 |
| 1356872246 | Tova Rogers | Dermatology | 1525 Clifton Road Suite 105, Atlanta, GA 30322 | 2017-03-23 |
| 1194271445 | Dina Amin | Dentist | 1365 Clifton,building B, Oral and Maxillofacial Surgery, Suite 2300, Atlanta, GA 30322 | 2016-08-28 |
| 1427404904 | Rita Kaur Kuwahara | Student in an Organized Health Care Education/Training Program | 100 Woodruff Circle, Suite 327, Atlanta, GA 30322 | 2016-05-13 |
| 1891176251 | Octav Cristea | Transplant Surgery | 1365 Clifton Road Northeast, Building B, 6th Floor, Atlanta, GA 30322 | 2015-06-11 |
| Find all providers in zip 30322 | ||||
| Taxonomy Code | 261QS0112X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| 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 |
|---|---|---|---|---|
| 1134682859 | North Atlanta Oral and Maxillofacial Surgery | Clinic/Center | 2555 Westside Pkwy Ste 350, Alpharetta, GA 30004-4191 | 2019-04-09 |
| 1659789170 | Blue Ocean Oral & Maxillofacial Surgery | Clinic/Center | 260 Rucker Rd, Suite 400, Alpharetta, GA 30004-4198 | 2014-07-28 |
| 1164449898 | Jeffrey R. Prinsell, Dmd, Md, P.C. | Clinic/Center | 1950 Spectrum Cir Se Ste B300, Marietta, GA 30067-1657 | 2006-07-17 |
| 1356983746 | Cornerstone Oral and Maxillofacial Surgery | Clinic/Center | 403 Cowart Ave, Valdosta, GA 31602-2635 | 2019-10-17 |
| 1962936302 | Robert S. Attia, Dmd, LLC | Clinic/Center | 1150 Grimes Bridge Rd, Suite 200, Roswell, GA 30075-3988 | 2017-04-12 |
| 1023327822 | North Georgia Oral Surgery, P.C. | Clinic/Center | 6304 Old Highway 5, Suite 102, Woodstock, GA 30188-2443 | 2010-09-28 |
| 1396064986 | Smyrna Oral and Maxillofacial Surgery and Implantology Center, LLC | Clinic/Center | 4849 S Cobb Dr Se, Unit 200, Smyrna, GA 30080-7145 | 2010-05-23 |
| 1285887497 | Robert J. Kakos Dds PC | Clinic/Center | 1150 Grimes Bridge Rd, Ste. 200, Roswell, GA 30075-3988 | 2008-10-31 |
| 1063682680 | Vidalia Oral and Maxillofacial Surgery, P.C. | Clinic/Center | 310 Maple Dr, Vidalia, GA 30474-8909 | 2008-03-11 |
| 1790899490 | John J. Beninato, D.d.s., P.C. | Clinic/Center | 21 John Maddox Dr Nw, Suite B, Rome, GA 30165-1413 | 2006-08-18 |
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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.