NPIMap

Organization Active NPI

Preston Ridge Dermatology, PC

  • Dermatology Physician
  • Alpharetta, GA
National Provider Identifier
1144470808
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
027412 Issued in GA
Legal business name
PRESTON RIDGE DERMATOLOGY, PC
Practice address
3155 N Point Pkwy
BLDG E Ste 100
Alpharetta, GA 30005-5494
Phone
(770) 475-6222
Fax
(770) 667-9522
NPI assigned
Sep 30, 2008
Last updated
Nov 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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

Authorized official

Name
Dr. Eileen Niren, M.D.NPI 1326133224
Title
President/Owner
Phone
(770) 475-6222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 027412 GA Primary

Addresses

Primary practice location

3155 N Point Pkwy
BLDG E Ste 100
Alpharetta, GA 30005-5494

Mailing address

3155 N Point Pkwy
BLDG E Ste 100
Alpharetta, GA 30005-5494
Phone (770) 475-6222

National Provider Directory

National Provider Directory

Locations

3155 North Point Pkwy
Ste E100
Alpharetta, GA 30005
Phone (770) 475-6222

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320278400000",
    "number": "1144470808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3155 N POINT PKWY",
            "address_2": "BLDG E STE 100",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300055494",
            "telephone_number": "770-475-6222",
            "fax_number": "770-667-9522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3155 N POINT PKWY",
            "address_2": "BLDG E STE 100",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300055494",
            "telephone_number": "770-475-6222",
            "fax_number": "770-667-9522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTON RIDGE DERMATOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-30",
        "last_updated": "2011-11-03",
        "status": "A",
        "authorized_official_last_name": "NIREN",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "770-475-6222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "027412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; 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.