Active NPI
Reza Miremami
- General Practice Dentistry
- Dunwoody, GA
National Provider Identifier
1164533550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN012283
- Practice address
- 2245 Vernon Oaks Way
Dunwoody, GA 30338-4468 - Phone
- (404) 642-4447
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN012283 | GA | Primary |
Addresses
Primary practice location
2245 Vernon Oaks Way
Dunwoody, GA 30338-4468
Mailing address
2245 Vernon Oaks Way
Dunwoody, GA 30338-4468
Phone (404) 642-4447
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160426001152 | GA | Order and Referring Only - Oral Surgery | 3476851544 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN012283 | GA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684454400000",
"number": "1164533550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2245 VERNON OAKS WAY",
"city": "DUNWOODY",
"state": "GA",
"postal_code": "303384468",
"telephone_number": "404-642-4447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2245 VERNON OAKS WAY",
"city": "DUNWOODY",
"state": "GA",
"postal_code": "303384468",
"telephone_number": "404-642-4447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIREMAMI",
"first_name": "REZA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2023-05-19",
"certification_date": "2023-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "DN012283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dunwoody, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.