Joseph Chandler Entrekin, DMD
Individual provider Active NPI General Practice Dentistry · Bremen, GA
NPI 1073245437 · NPPES record last updated Jun 25, 2022
Key facts
- NPI
- 1073245437
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DN122693 (GA)
- Practice address
- 302 Laurel St
Bremen, GA 30110-2124 - Phone
- (770) 537-4439
- NPI assigned
- Jun 25, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN122693 | GA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carrollton Family Dentistry LLC | General Practice | Current | Accepting new patients |
| Bremen Dental Depot LLC | Current |
Accepting new patients |
Locations
302 Laurel St
Bremen, GA 30110
Phone (770) 537-4439
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN122693 | GA | Yes |
Addresses
Primary practice location
302 Laurel St
Bremen, GA 30110-2124
Mailing address
501 Valley Run Dr
Bremen, GA 30110-2411
Phone (770) 537-3574
Other providers in Bremen, GA
- Erin Ellison
- John Endress
- Johannes D Engelbrecht
- Diane Elizabeth Engels
- Joseph Cameron Entrekin
- Kelley Entrekin
- Eric S. Leithner, DMD, PC
- Alyssa Morgan Eriquezzo
- Amy Jordan Eubanks
- David Farmer
All providers in Bremen, GA · General Practice Dentistry in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.