Individual provider Active NPI

Nancy Jane Myerson, DMD

  • General Practice Dentistry
  • Brookhaven, GA
National Provider Identifier
1104972488
Registry record updated Aug 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11645 Issued in GA
Practice address
3575 Durden Dr NE Ste 102
Brookhaven, GA 30319
Phone
(770) 451-0611
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11645 GA Primary

Addresses

Primary practice location

3575 Durden Dr NE Ste 102
Brookhaven, GA 30319

Mailing address

4625 Vermack PL
Atlanta, GA 30338-5144
Phone (678) 656-7009

Other practice location 1

3400 Old Milton Pkwy Ste A430
Alpharetta, GA 30005-3763
Phone (770) 667-0669

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1104972488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4625 VERMACK PL",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303385144",
            "telephone_number": "678-656-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 DURDEN DR NE STE 102",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "30319",
            "telephone_number": "770-451-0611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Old Milton Pkwy Ste A430",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300053763",
            "country_code": "US",
            "telephone_number": "770-667-0669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYERSON",
        "first_name": "NANCY",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "11645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; 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.