Emma Deal

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN015840 Issued in GA

Practice address

4150 Five Forks Trickum Rd SW
Lilburn, GA 30047-3130

Phone

(770) 717-7225

NPI assigned

Jun 12, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1093374126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5755 GLENRIDGE DR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 FIVE FORKS TRICKUM RD SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473130",
            "telephone_number": "770-717-7225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4150 Five Forks Trickum Rd SW",
            "address_purpose": "LOCATION",
            "city": "Lilburn",
            "state": "GA",
            "postal_code": "300473130",
            "country_code": "US",
            "telephone_number": "770-717-7225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEAL",
        "first_name": "EMMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Windell C Davis-Boutte, M.D.
• Carol Dawn Davis, MD
• Jeffrey William Davis, PTA
• Richard Lee Dawson
• Yolanda DS Dawson
• Carmen Jagolino Dela Cruz-Placer
• Anabel Delgado-Gaono
• Shayna Dennis
• Laura Dennison, MA, CCC-A
• Dental Professionals of Georgia, P.C.

• General Practice Dentistry in Lilburn, GA
• Providers in Lilburn, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; 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.