Mountain View Oral Surgery & Dental Implants LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN014013 Issued in GA

Legal business name

MOUNTAIN VIEW ORAL SURGERY & DENTAL IMPLANTS LLC

Doing business as

Mountain View Oral Surgery & Dental Implants

Practice address

121 Marble Mill Rd NW
Suite 202
Marietta, GA 30060-7959

Phone

(770) 218-9135

Fax

(866) 224-2735

NPI assigned

Aug 1, 2012

Organization subpart

No

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

Authorized official

Name

Mark A Chishom, DMD

Title

Oral Surgeon

Phone

(770) 218-9135

Specialties & licenses 1

Addresses

Other names 1

• Mountain View Oral Surgery & Dental Implants Doing business as

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343779200000",
    "number": "1104172741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 MARBLE MILL RD NW",
            "address_2": "SUITE 202",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607959",
            "telephone_number": "770-218-9135",
            "fax_number": "866-224-2735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 MARBLE MILL RD NW",
            "address_2": "SUITE 202",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607959",
            "telephone_number": "770-218-9135",
            "fax_number": "866-224-2735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN VIEW ORAL SURGERY & DENTAL IMPLANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-01",
        "last_updated": "2012-08-01",
        "status": "A",
        "authorized_official_last_name": "CHISHOM",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ORAL SURGEON",
        "authorized_official_telephone_number": "770-218-9135",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "DN014013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain View Oral Surgery & Dental Implants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nabil Michael Motlagh, DPT, PT
• George Omar Moujaes, MA
• Kierra Jahnae Moultrie, MSW
• William Brackett Moultrie
• Mountain Park Dialysis Center, LLC
• Mountains Women'S Center LLC
• Stephanie Moyal, LCSW
• Joseph H Moyers, MD
• MRM Medical Group
• Gaspar Msangi, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Marietta, GA
• Providers in Marietta, GA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2012; 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.