Gofs Stockbridge

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

DN014207 Issued in GA

Legal business name

GOFS STOCKBRIDGE

Practice address

225 Country Club Dr
#110
Stockbridge, GA 30281

Phone

(678) 905-9066

Fax

(678) 401-4725

NPI assigned

Jan 26, 2018

Organization subpart

No

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

Authorized official

Name

Giana Houston

Title

Cfo

Phone

(404) 384-1181

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1516924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516924800000",
    "number": "1114425964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 COUNTRY CLUB DR",
            "address_2": "#110",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "30281",
            "telephone_number": "678-905-9066",
            "fax_number": "678-401-4725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 COUNTRY CLUB DR",
            "address_2": "#110",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "30281",
            "telephone_number": "678-905-9066",
            "fax_number": "678-401-4725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOFS STOCKBRIDGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-26",
        "last_updated": "2018-01-26",
        "status": "A",
        "authorized_official_last_name": "HOUSTON",
        "authorized_official_first_name": "GIANA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "404-384-1181"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "GA",
            "license": "DN014207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Stockbridge, GA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.