Active NPI
Bertrand E Scannell, DDS
- General Practice Dentistry
- Atlanta, GA
National Provider Identifier
1033209101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 09289
- Practice address
- 303 Peachtree St
Suite Ll150
Atlanta, GA 30308-3201 - Phone
- (404) 525-2741
- Fax
- (404) 589-0043
- NPI assigned
- Oct 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 09289 | GA | Primary |
Addresses
Primary practice location
303 Peachtree St
Suite Ll150
Atlanta, GA 30308-3201
Mailing address
303 Peachtree St
Suite Ll150
Atlanta, GA 30308-3201
Phone (404) 525-2741
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09289 | GA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693958400000",
"number": "1033209101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "303 PEACHTREE ST",
"address_2": "SUITE LL150",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303083201",
"telephone_number": "404-525-2741",
"fax_number": "404-589-0043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 PEACHTREE ST",
"address_2": "SUITE LL150",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303083201",
"telephone_number": "404-525-2741",
"fax_number": "404-589-0043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCANNELL",
"first_name": "BERTRAND",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2023-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "09289",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.