Individual provider Active NPI

John T Uetsuki, DMD

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1114911575
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11727 Issued in GA
Practice address
2847 Henderson Mill Rd
Atlanta, GA 30341-5772
Phone
(770) 496-0496
Fax
(770) 496-1758
NPI assigned
Aug 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 11727 GA Primary

Addresses

Primary practice location

2847 Henderson Mill Rd
Atlanta, GA 30341-5772

Mailing address

2847 Henderson Mill Rd
Atlanta, GA 30341-5772
Phone (770) 496-0496

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
11727GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Henderson Mill Dental Care, PC General Practice Past 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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1114911575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2847 HENDERSON MILL RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303415772",
            "telephone_number": "770-496-0496",
            "fax_number": "770-496-1758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2847 HENDERSON MILL RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303415772",
            "telephone_number": "770-496-0496",
            "fax_number": "770-496-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UETSUKI",
        "first_name": "JOHN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "11727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.