Individual provider Active NPI

Joseph Marvin Merritt, DMD

  • General Practice Dentistry
  • Roswell, GA
National Provider Identifier
1073034435
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN015466 Issued in GA
Practice address
597 W Crossville Rd
Roswell, GA 30075-2695
Phone
(770) 992-5858
NPI assigned
Jul 6, 2017
Last updated
Dec 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN015466 GA Primary

Addresses

Primary practice location

597 W Crossville Rd
Roswell, GA 30075-2695

Mailing address

597 W Crossville Rd
Roswell, GA 30075-2695
Phone (770) 992-5858

Other practice location 1

312 Tribble Gap Rd
Cumming, GA 30040-2440
Phone (770) 887-1399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171110001305 GA Order and Referring Only - DentistPractitioner - Dentist 7517223399

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Forsyth Dental Partners, LLC PastSince Sep 15, 2024 Accepting new patients
Howard Family Dental-Hinesville, LLC General Practice Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1499299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1073034435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "597 W CROSSVILLE RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300752695",
            "telephone_number": "770-992-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "597 W CROSSVILLE RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300752695",
            "telephone_number": "770-992-5858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "312 Tribble Gap Rd",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300402440",
            "country_code": "US",
            "telephone_number": "770-887-1399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERRITT",
        "first_name": "JOSEPH",
        "middle_name": "MARVIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-06",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.