ATLANTA ORAL & MAXILLOFACIAL SURGERY, P.C. (NPI# 1619019874) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619019874 |
| Entity Type | Organization |
| Organization Name | ATLANTA ORAL & MAXILLOFACIAL SURGERY, P.C. |
| Practice Address |
3875 Holcomb Bridge Rd Ste 4 Norcross GA 30092-2269 |
| Practice Telephone | 7707291481 |
| Practice Fax Number | 7704482225 |
| Mailing Telephone | 7707291481 |
| Mailing Fax Number | 7704482225 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | CHRISTIAN LOETSCHER (PRESIDENT) |
| Authorized Official Telephone | 7707291481 |
| Authorized Official Credential | D.D.S, M.S |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DN010907 | GA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | UNITED CONCORDIA | 667702 | 01 |
| Street Address |
3875 HOLCOMB BRIDGE RD STE 4 |
| City | NORCROSS |
| State | GA |
| Zip Code | 30092-2269 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922366228 | Robert Keith Broome Jr. | Dentist | 3875 Holcomb Bridge Rd, Suite 1, Norcross, GA 30092-5287 | 2012-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083172035 | Tebo Dentistry for Kids Peachtree Corners, LLC | Clinic/Center | 6460 Spalding Drive, Suite C, Peachtree Corners, GA 30092 | 2019-03-08 |
| 1043794472 | Cai Hong Senior Services Inc | Clinic/Center | 4093 Spalding Hollow, Peatree Corners, GA 30092 | 2018-09-21 |
| 1952810566 | Children In Motion Therapy Services LLC | Occupational Therapist | 5655 Peachtree Pkwy Ste 117, Norcross, GA 30092 | 2017-09-26 |
| 1922517945 | Infinity Wellness Solutions LLC | Emergency Medicine | 3240 Pointe Parkway, Suite 100, Norcross, GA 30092 | 2017-09-21 |
| 1346769593 | Global Diagnostic Labs, LLC | Pathology | 3240 Pointe Pkwy Ste 200, Norcross, GA 30092 | 2017-09-19 |
| 1467993345 | Boris Mcguire Day | Counselor | 3597 Monticello Commons, Norcross, GA 30092 | 2017-03-13 |
| 1598205239 | Iwc East LLC | Internal Medicine | 40 Technology Parkway, #300, Norcross, GA 30092 | 2017-02-28 |
| 1851744254 | Lms Surgical Services | Specialist/Technologist, Other | 6050 Peachtree Pkwy Suite240-358, Norcross, GA 30092 | 2016-07-20 |
| 1881085603 | A Hand To Hold | Home Health | 3459 Holcomb Bridge Rd., Suite 100, Peachtree Corners, GA 30092 | 2015-02-16 |
| 1790196467 | Wranglehurst, P.C. | Dentist | 3850 Holcomb Br. Rd, Suite 230, Norcross, GA 30092 | 2014-05-15 |
| Find all providers in zip 30092 | ||||
| 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 |
|---|---|---|---|---|
| 1750799490 | Mh Oral Surgery LLC | Dentist | 6000 Singleton Rd, Norcross, GA 30093-1968 | 2014-07-25 |
| 1699919126 | Damian Richard Jimenez | Dentist | 5635 Peachtree Pkwy, Suite 100, Norcross, GA 30092-2879 | 2009-04-28 |
| 1215108220 | Wm.henry Wall | Dentist | 5139 Jimmy Carter Blvd Ste 201, Norcross, GA 30093-1638 | 2008-03-18 |
| 1477699510 | Raymon Eric Allison Jr. | Dentist | 6060 Mcdonough Dr, Suite 1, Norcross, GA 30093 | 2007-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598370454 | Karin Davis, Dmd, PC | Dentist | 3630 Savannah Pl Ste 250, Duluth, GA 30096-6394 | 2020-09-08 |
| 1649740796 | Sandy Springs Oral Surgery, LLC | Dentist | 5555 Peachtree Dunwoody Rd Ste G56, Atlanta, GA 30342-1700 | 2018-12-02 |
| 1700354677 | Cobb Oral Surgery and Dental Implant Center PC | Dentist | 2155 Post Oak Tritt Rd Ste 500, Marietta, GA 30062-8609 | 2018-11-08 |
| 1245721216 | East Atlanta Oral, Implant and Facial Surgery Center | Dentist | 519 Memorial Dr Se Unit D1, Atlanta, GA 30312-2218 | 2018-05-24 |
| 1497261960 | Rockwell Oral and Facial Surgery LLC | Dentist | 675 N. Highland Ave Ne, Suite 100, Atlanta, GA 30306 | 2017-12-20 |
| 1225543515 | Oral & Facial Surgery of East Alabama, LLC | Dentist | 4405 N Stadium Drive, Suite A, Columbus, GA 31909 | 2017-12-08 |
| 1194271445 | Dina Amin | Dentist | 1365 Clifton,building B, Oral and Maxillofacial Surgery, Suite 2300, Atlanta, GA 30322 | 2016-08-28 |
| 1457735995 | Coastal Oral Surgery Associates | Dentist | 110 Office Park Ln, Suite 104, Saint Simons Island, GA 31522-6601 | 2015-07-15 |
| 1497140719 | Chelsea Elizabeth Johnson | Dentist | 4405 N Stadium Dr Ste A, Columbus, GA 31909-1884 | 2015-04-02 |
| 1386038396 | Timothy C Jaeger | Dentist | 1360 Caduceus Way Ste 101, Watkinsville, GA 30677-7300 | 2015-03-27 |
| Find all providers with the same taxonomy | ||||
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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.