ANTWAN LONDELL TREADWAY (NPI# 1972616878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972616878 |
| Entity Type | Individual |
| Full Name | ANTWAN LONDELL TREADWAY |
| Credential | D.M.D. |
| Practice Address |
1790 Mulkey Rd Suite 3a Austell GA 30106-1122 |
| Practice Telephone | 7709412476 |
| Practice Fax Number | 7709415710 |
| Mailing Telephone | 7709412476 |
| Mailing Fax Number | 7709415710 |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DN13765 | FL | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
12209 | GA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000849439B | 05 | |
| GA | 000849439C | 05 |
| Street Address |
1790 MULKEY RD SUITE 3A |
| City | AUSTELL |
| State | GA |
| Zip Code | 30106-1122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225036015 | Kathy Mcknight Lockett | Nurse Practitioner | 1790 Mulkey Rd, Austell, GA 30106-1122 | 2005-07-14 |
| 1891340667 | Skitzy Joy Tobias | Nurse Practitioner | 1790 Mulkey Rd, Austell, GA 30106-1122 | 2019-08-07 |
| 1427485986 | Wellstar Medical Group, LLC | Otolaryngology | 1790 Mulkey Rd, Suite 7, Austell, GA 30106-1122 | 2013-09-30 |
| 1174870430 | West Atlanta Endodontics | Dentist | 1790 Mulkey Rd, Suite 2, Austell, GA 30106-1122 | 2012-08-06 |
| 1982900551 | Wellstar Medical Group, LLC | Otolaryngology | 1790 Mulkey Rd, Austell, GA 30106-1122 | 2011-01-31 |
| 1790081362 | Wellstar Medical Group, LLC | Internal Medicine | 1790 Mulkey Rd, Suite 5-a, Austell, GA 30106-1122 | 2011-01-31 |
| 1295031839 | Wellstar Medical Group, LLC | Family Medicine | 1790 Mulkey Rd, Suite 8-a, Austell, GA 30106-1122 | 2011-01-30 |
| 1477878759 | Kelli Pitt | Internal Medicine | 1790 Mulkey Rd, Suite 5a, Austell, GA 30106-1122 | 2010-03-30 |
| 1952533382 | Sarah Cosci Baker | Audiologist-Hearing Aid Fitter | 1790 Mulkey Rd, Suite 7, Austell, GA 30106-1122 | 2009-08-18 |
| 1912107434 | David W Norrington | Dentist | 1790 Mulkey Rd, Suite 2, Austell, GA 30106-1122 | 2007-07-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073126231 | Courtney Lashune Dorsett | Nurse Practitioner | 1005 Cureton Drive, Austell, Austell, GA 30106 | 2020-08-27 |
| 1184240491 | Brian H Eves | Dietitian, Registered | 3972 Brantley Drive, Austell, GA 30106 | 2020-06-23 |
| 1669014486 | Jesse Mccoy | Registered Nurse | 3950 Austell Rd., Austell, GA 30106 | 2019-10-14 |
| 1427522820 | Envision Optics LLC | Optometrist | 1680 E West Connector, Austell, GA 30106 | 2019-01-18 |
| 1972042380 | Thomas Dental Group | Clinic/Center | 1133 East West Connector, Suite 120, Austell, GA 30106 | 2017-02-17 |
| 1245779792 | Colton Dental Group | Clinic/Center | 2495 East-west Connector, Ste 60, Austell, GA 30106 | 2017-02-16 |
| 1144691684 | Georgia Dental Professionals, PC | Dentist | 780 East West Connector Sw, Suite 108, Austell, GA 30106 | 2015-10-09 |
| 1285013714 | Ikeade Bello Alamu | Nurse Practitioner | 2870 Betula Drive, Austell, GA 30106 | 2015-05-29 |
| 1376922211 | Jessica Williams | Obstetrics & Gynecology | 1700 Hospital South Dr Ste 500, Austell, GA 30106 | 2015-05-26 |
| 1558799593 | Tonya Renee Baldwin | Speech-Language Pathologist | 4229 Brass Trl., Austell, GA 30106 | 2013-10-30 |
| Find all providers in zip 30106 | ||||
| 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 |
|---|---|---|---|---|
| 1386945863 | Crbappl Oral Surgery LLC | Dentist | 1678 Mulkey Rd, Austell, GA 30106-1147 | 2010-11-15 |
| 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.