Individual provider Active NPI

Andrea Rainoff, DMD

  • General Practice Dentistry
  • Brookhaven, GA
National Provider Identifier
1164205282
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN123242 Issued in GA
Practice address
3575 Durden Dr NE Ste 102
Brookhaven, GA 30319-2254
Phone
(770) 262-7898
NPI assigned
Aug 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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 DN123242 GA Primary

Addresses

Primary practice location

3575 Durden Dr NE Ste 102
Brookhaven, GA 30319-2254

Mailing address

3772 Ellsworth Way NE
Atlanta, GA 30319-2155
Phone (770) 331-8841

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
DN123242GAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1164205282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3772 ELLSWORTH WAY NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303192155",
            "telephone_number": "770-331-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 DURDEN DR NE STE 102",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303192254",
            "telephone_number": "770-262-7898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAINOFF",
        "first_name": "ANDREA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN123242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.