Organization Active NPI

Nexdental Associates Woodstock LLC

  • General Practice Dentistry
  • Woodstock, GA
National Provider Identifier
1003952128
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NEXDENTAL ASSOCIATES WOODSTOCK LLC
Practice address
8950 Main St Ste 120
Woodstock, GA 30188-4916
Phone
(770) 926-4447
Fax
(770) 924-6813
NPI assigned
Jan 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Gustave Joseph Peluso III, DMD
Title
100 Managing Member
Phone
(770) 926-4447

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

8950 Main St Ste 120
Woodstock, GA 30188-4916

Mailing address

8950 Main St Ste 120
Woodstock, GA 30188-4916
Phone (770) 926-4447

National Provider Directory

National Provider Directory

Locations

8950 Main St
Ste 120
Woodstock, GA 30188
Phone (770) 926-4447

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003952128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 MAIN ST STE 120",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884916",
            "telephone_number": "770-926-4447",
            "fax_number": "770-924-6813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8950 MAIN ST STE 120",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884916",
            "telephone_number": "770-926-4447",
            "fax_number": "770-924-6813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEXDENTAL ASSOCIATES WOODSTOCK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PELUSO",
        "authorized_official_first_name": "GUSTAVE",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "100 MANAGING MEMBER",
        "authorized_official_telephone_number": "770-926-4447",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.