Southeast Oral Diagnostics LLC

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

Legal business name

SOUTHEAST ORAL DIAGNOSTICS LLC

Practice address

282 Rucker Rd Ste 110
Alpharetta, GA 30004-5826

Phone

(770) 992-4844

NPI assigned

Jan 5, 2026

Last updated

Jan 5, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stephanie WetzelNPI 1528217940

Title

Owner/ Dentist

Phone

(770) 992-4844

Specialties & licenses 1

Addresses

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephanie L Wetzel, DDS

  • Oral and Maxillofacial Pathology Dentistry
  • Alpharetta, GA
  • NPI 1528217940
  NPD Authorized official
• Michael McHaney Demo, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Atlanta, GA
  • NPI 1083873640
  NPD (past)
• Gregory Paul Marks, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Atlanta, GA
  • NPI 1932223740
  NPD (past)
• John Howard Muse, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Decatur, GA
  • NPI 1558498295
  NPD (past)

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

{
    "created_epoch": "1767571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767571200000",
    "number": "1063378966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 PRESTON AVE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405021532",
            "telephone_number": "770-992-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 RUCKER RD STE 110",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300045826",
            "telephone_number": "770-992-4844"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Pharr Rd NE Ste 325",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303053450",
            "country_code": "US",
            "telephone_number": "404-233-8221",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "755 Commerce Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300302613",
            "country_code": "US",
            "telephone_number": "404-378-2331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5555 Peachtree Dunwoody Rd Ste G56",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303421700",
            "country_code": "US",
            "telephone_number": "404-252-5626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHEAST ORAL DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-05",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A",
        "authorized_official_last_name": "WETZEL",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER/ DENTIST",
        "authorized_official_telephone_number": "770-992-4844",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Pathology Dentistry in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Oral and Maxillofacial Pathology Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; 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.