NPIMap

Organization Active NPI

Georgia Endodontic Specialists

  • Endodontics
  • Duluth, GA
National Provider Identifier
1174794002
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
10636 Issued in GA
Legal business name
GEORGIA ENDODONTIC SPECIALISTS
Practice address
9590 Medlock Bridge Rd
Suite G
Duluth, GA 30097
Phone
(770) 232-5112
Fax
(770) 232-5115
NPI assigned
Mar 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Dr. Les Hale Kravitz, DDSNPI 1255515805
Title
President
Phone
(770) 232-5112

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 10636 GA Primary

Addresses

Primary practice location

9590 Medlock Bridge Rd
Suite G
Duluth, GA 30097

Mailing address

9590 Medlock Bridge Rd
Suite G
Duluth, GA 30097
Phone (770) 232-5112

Other names 1

  • North Georgia Endodontic Specialists Doing business as

National Provider Directory

National Provider Directory

Locations

9590 Medlock Bridge Rd
Ste G
Johns Creek, GA 30097
Phone (770) 232-5112

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1174794002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9590 MEDLOCK BRIDGE RD",
            "address_2": "SUITE G",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "770-232-5112",
            "fax_number": "770-232-5115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9590 MEDLOCK BRIDGE RD",
            "address_2": "SUITE G",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "770-232-5112",
            "fax_number": "770-232-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA ENDODONTIC SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-19",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "KRAVITZ",
        "authorized_official_first_name": "LES",
        "authorized_official_middle_name": "HALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-232-5112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "GA",
            "license": "10636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Georgia Endodontic Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.