Active NPI
Amar Mistry, DDS
- General Practice Dentistry
- Dunwoody, GA
National Provider Identifier
1104274976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN122972
- Practice address
- 2472 Jett Ferry Rd Ste 430
Dunwoody, GA 30338-3059 - Phone
- (770) 396-8061
- NPI assigned
- Jun 2, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 30.025024 | OH | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Dentistry | 1223G0001X | DN122972 | GA | Primary |
Addresses
Primary practice location
2472 Jett Ferry Rd Ste 430
Dunwoody, GA 30338-3059
Mailing address
6403 Country Ridge Dr
Troy, MI 48098-6549
Other practice location 1
640 Brighton Ave
#1
Portland, ME 04102
Phone (207) 874-1028
Other practice location 2
9000 N Main St Ste 207
Englewood, OH 45415-1165
Phone (937) 836-7282
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN122972 | GA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mount Vernon Dental Group, LLC | Current | Accepting new patients | |
| Thomas K Sparkman, DDS, PC | Past | Accepting new patients | |
| Pfdental Reddy Inc | General Practice | Past | Accepting new patients |
Locations
2472 Jett Ferry Rd
Ste 430
Dunwoody, GA 30338
Phone (770) 396-8061
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Dunwoody, GA
- NPI 1528665486
-
- Dentist
- Dunwoody, GA
- NPI 1356425987
-
- General Practice Dentistry
- Dayton, OH
- NPI 1609297134
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735776000000",
"number": "1104274976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6403 COUNTRY RIDGE DR",
"city": "TROY",
"state": "MI",
"postal_code": "480986549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2472 JETT FERRY RD STE 430",
"city": "DUNWOODY",
"state": "GA",
"postal_code": "303383059",
"telephone_number": "770-396-8061"
}
],
"practiceLocations": [
{
"address_1": "640 Brighton Ave",
"address_2": "#1",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "ME",
"postal_code": "04102",
"country_code": "US",
"telephone_number": "207-874-1028",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9000 N Main St Ste 207",
"address_purpose": "LOCATION",
"city": "Englewood",
"state": "OH",
"postal_code": "454151165",
"country_code": "US",
"telephone_number": "937-836-7282",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MISTRY",
"first_name": "AMAR",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-02",
"last_updated": "2025-01-02",
"certification_date": "2025-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "30.025024",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "DN122972",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dunwoody, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.