Raymond Charles Dickey Jr., DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN014642 Issued in GA

Practice address

117 First National Dr
Dallas, GA 30157-3430

Phone

(770) 672-5629

NPI assigned

Apr 8, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Northwest Oral & Maxillofacial Surgery Associates, P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Marietta, GA
  • NPI 1194732735
  NPD (past)
• Southwest Maxillofacial Surgery & Implant Center

  • Oral and Maxillofacial Surgery (Dentist)
  • Atlanta, GA
  • NPI 1073743795
  NPD (past)

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

{
    "created_epoch": "1365379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1194168328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 GOLF CREST DR STE 209",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301012698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 FIRST NATIONAL DR",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301573430",
            "telephone_number": "770-672-5629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKEY",
        "first_name": "RAYMOND",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MO",
            "license": "2019013206",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "DN014642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karla Deloatch, LPN
• Danielle Lynne Deramus, OT
• Alina Ariel Devito, RBT
• Robert Dean Devlin II
• Diamond Community Living, LLC
• Jaci Michelle Dillard
• Armand Babou Diouf
• Kenzie Dittmar, PA
• Dmdprnt LLC
• Paula M Dobbs, LCSW

• Oral and Maxillofacial Surgery (Dentist) in Dallas, GA
• Providers in Dallas, GA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.