Individual provider Active NPI

Alexa Vieira

  • General Practice Dentistry
  • Smyrna, GA
National Provider Identifier
1114777083
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN123769 Issued in GA
Practice address
2995 Atlanta Rd SE Ste 200
Smyrna, GA 30080-3650
Phone
(678) 203-3463
NPI assigned
Mar 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X DN123769 GA Primary

Addresses

Primary practice location

2995 Atlanta Rd SE Ste 200
Smyrna, GA 30080-3650

Mailing address

1444 Wicker Wood PL SE
Smyrna, GA 30080-1175
Phone (650) 546-9229

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

State licenses

LicenseStateTypeSpecialty
DN123769GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Smyrna Dentist Office, PC General Practice PastSince Jun 23, 2025 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1114777083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1444 WICKER WOOD PL SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300801175",
            "telephone_number": "650-546-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2995 ATLANTA RD SE STE 200",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300803650",
            "telephone_number": "678-203-3463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIEIRA",
        "first_name": "ALEXA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "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": "DN123769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.

Verify at the official NPI Registry.