DR. JENNIFER A DATTOLO (NPI# 1962596627) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962596627 |
| Entity Type | Individual |
| Full Name | DR. JENNIFER A DATTOLO |
| Credential | O.D. |
| Practice Address |
1075 Buckhead Xing Suite 130 Woodstock GA 30189-4262 |
| Practice Telephone | 7707025996 |
| Mailing Telephone | 7707025996 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2016-06-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152WV0400X |
Optometrist Specialization: Vision Therapy |
001878 | GA | Eye and Vision Services Providers |
| Street Address |
1075 BUCKHEAD XING SUITE 130 |
| City | WOODSTOCK |
| State | GA |
| Zip Code | 30189-4262 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568811610 | Bella Ottica LLC | Optometrist | 1075 Buckhead Xing, Suite 130, Woodstock, GA 30189-4262 | 2016-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801494356 | Susan Iruku | Pharmacist | 12050 Ga-92 #112, Woodstock, GA 30189 | 2020-10-15 |
| 1598267437 | Kelly Sierra | Nurse Practitioner | 100 Stoneforest Dr Ste 300, Woodstock, GA 30189 | 2018-03-07 |
| 1548770449 | Chandra Johnson | Nurse Practitioner | 295 Molly Lane Ste 150, Woodstock, GA 30189 | 2017-10-05 |
| 1083133912 | Amanda Bostock Sowisdral | Physician Assistant | 250 Parkbrooke Pl Ste 300, Woodstock, GA 30189 | 2017-09-12 |
| 1780101659 | Laura C Koch Woodstock LLC Dba Fountain View Dentistry | Dentist | 1816 Eagle Drive, Building 200-a, Woodstock, GA 30189 | 2017-08-23 |
| 1265954788 | Vicky Morton Bryan | Nurse Practitioner | 422 Sycamore Trail, Woodstock, GA 30189 | 2017-07-17 |
| 1063933588 | Marietta Eye Clinic, Pa | Optometrist | 2990 Eagle Dr Ste 110, Woodstock, GA 30189 | 2017-07-06 |
| 1275914749 | Nrup Tolat | Podiatrist | 100 Stoneforest Dr Ste 120, Woodstock, GA 30189 | 2015-06-10 |
| 1558781534 | Mary Jansson Carmon | Nurse Practitioner | 1000 Towne Lake Pkwy, Woodstock, GA 30189 | 2014-04-17 |
| 1518388941 | Afc Physicians of Georgia, PC | General Practice | 6440 Bells Ferry Rd, Woodstock, GA 30189 | 2014-01-03 |
| Find all providers in zip 30189 | ||||
| Taxonomy Code | 152WV0400X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Specialization | Vision Therapy |
| Optometrists who specialize in vision therapy as a treatment process used to improve vision function. It includes a broad range of developmental and rehabilitative treatment programs individually prescribed to remediate specific sensory, motor and/or visual perceptual dysfunctions. |
| Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669880936 | Pediatric Vision Development Center of Gwinnett | Optometrist | 2055 Hamilton Creek Pkwy, Ste 120, Dacula, GA 30019-7204 | 2014-07-30 |
| 1538499033 | Vision Savers, Inc | Optometrist | 96 N Bennett St, Forsyth, GA 31029-1977 | 2010-01-05 |
| 1871716654 | James Edwin Behrens | Optometrist | 350 Ferst Dr Nw, Atlanta, GA 30332-0001 | 2007-04-10 |
| 1578667986 | Leonard Achiron | Optometrist | 3619 S Fulton Ave, Suite 100, Hapeville, GA 30354-1710 | 2006-09-08 |
| 1659789923 | Pediatric Vision Development Center of Forsyth | Optometrist | 2920 Ronald Reagan Blvd, Ste 104, Cumming, GA 30041-6206 | 2014-07-30 |
| 1417288671 | Vision Savers, Inc | Optometrist | 2203 Watson Blvd, Suite 55, Warner Robins, GA 31093-2994 | 2010-01-27 |
| 1093045593 | Vision Savers, Inc | Optometrist | 2103 Veterans Blvd, Suite 5, Dublin, GA 31021-7502 | 2010-01-05 |
| 1568792067 | Vision Savers | Optometrist | 3661 Eisenhower Pkwy, Suite 55, Macon, GA 31206-3649 | 2010-01-05 |
| 1316129463 | Andrea J. Washington O.d. PC | Optometrist | 4106 Mill St Ne Ste A, Covington, GA 30014-2539 | 2007-11-30 |
| 1427177146 | Rachael Sweeney | Optometrist | 5380 Roswell Rd Ne, Atlanta, GA 30342-1916 | 2007-03-28 |
| 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.