Individual provider Active NPI

Gary Wayne Parnes, BSA, DDS

  • General Practice Dentistry
  • Alpharetta, GA
National Provider Identifier
1124109384
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10279 Issued in GA
Practice address
875 N Main St
Suite 359
Alpharetta, GA 30004-8373
Phone
(770) 475-4434
Fax
(770) 475-7756
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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 10279 GA Primary

Addresses

Primary practice location

875 N Main St
Suite 359
Alpharetta, GA 30004-8373

Mailing address

2280 Hopewell Plantation Drive
Alpharetta, GA 30004
Phone (678) 566-3094

Other identifiers 2

IdentifierTypeStateIssuer
100362MedicaidGA
9179575MedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151216001289 GA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5799086773

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10279GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Parnes Family Dentistry II LLC 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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1124109384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2280 HOPEWELL PLANTATION DRIVE",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "30004",
            "telephone_number": "678-566-3094",
            "fax_number": "678-990-4072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 N MAIN ST",
            "address_2": "SUITE 359",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300048373",
            "telephone_number": "770-475-4434",
            "fax_number": "770-475-7756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARNES",
        "first_name": "GARY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "BSA, DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "10279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100362",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9179575",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

Verify at the official NPI Registry.