Organization Active NPI

Zodiac Medical LLC

  • Internal Medicine Physician
  • Lawrenceville, GA
National Provider Identifier
1083344576
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ZODIAC MEDICAL LLC
Doing business as
ADVANCED MEDICAL CARE
Practice address
1180 McKendree Church Rd Ste 202
Lawrenceville, GA 30043-5207
Phone
(470) 292-3122
Fax
(404) 738-1614
NPI assigned
Jun 16, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Authorized official

Name
Dr. Dong Vien Dang, MDNPI 1275875551
Title
Owner
Phone
(470) 633-1970

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X Primary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X
Sleep Medicine (Internal Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RS0012X

Addresses

Primary practice location

1180 McKendree Church Rd Ste 202
Lawrenceville, GA 30043-5207

Mailing address

1180 McKendree Church Rd Ste 202
Lawrenceville, GA 30043-5207
Phone (470) 292-3122

Other names 1

  • ADVANCED MEDICAL CARE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220829003795 GA Part B Supplier - Clinic/Group Practice 8022492792 Receives reassigned benefits from 3 practitioners
Practice locations: Lawrenceville, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2280549Zodiac Medical LLC1180 McKendree Church Road, Suite 202, Lawrenceville, GA 30043Certificate of waiverApr 20, 2027

National Provider Directory

National Provider Directory

Locations

1180 McKendree Church Rd
Lawrenceville, GA 30043

7183 Jonesboro Rd
Ste 100
Morrow, GA 30260
Phone (470) 221-2221

3985 Steve Reynolds Blvd
Ste K102
Norcross, GA 30093
Phone (678) 367-0390

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": "1655337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1083344576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 MCKENDREE CHURCH RD STE 202",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435207",
            "telephone_number": "470-292-3122",
            "fax_number": "404-738-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 MCKENDREE CHURCH RD STE 202",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435207",
            "telephone_number": "470-292-3122",
            "fax_number": "404-738-1614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZODIAC MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-16",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A",
        "authorized_official_last_name": "DANG",
        "authorized_official_first_name": "DONG",
        "authorized_official_middle_name": "VIEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "470-633-1970",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADVANCED MEDICAL CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.