Periodontal Specialists of Vinings

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

PERIODONTAL SPECIALISTS OF VININGS

Practice address

100 Galleria Pkwy SE
Suite 250
Atlanta, GA 30339-3179

Phone

(678) 236-0500

Fax

(678) 236-0586

NPI assigned

Nov 3, 2014

Last updated

Jul 18, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Husam Bezreh, DMD, MS, ABPNPI 1245257898

Title

Owner

Phone

(678) 677-9288

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Husam Mohamad Bezreh, DMD

  • Periodontics
  • Atlanta, GA
  • NPI 1245257898
  NPD Authorized official

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

{
    "created_epoch": "1414972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689638400000",
    "number": "1205231271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GALLERIA PKWY SE",
            "address_2": "SUITE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393179",
            "telephone_number": "678-236-0500",
            "fax_number": "678-236-0586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GALLERIA PKWY SE",
            "address_2": "SUITE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393179",
            "telephone_number": "678-236-0500",
            "fax_number": "678-236-0586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIODONTAL SPECIALISTS OF VININGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-03",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A",
        "authorized_official_last_name": "BEZREH",
        "authorized_official_first_name": "HUSAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-677-9288",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MS, ABP"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Perimeter Spine and Rehabilitation LLC
• Perimeter Therapy Associates LLC
• Perimeter Vision Care, LLC (Atlanta Eye Group Tucker)
• Perimeter Vision Care, LLC (Atlanta Eye Group)
• Periodontal Associates PC
• Dylan Perito
• Cecil Katherine Perkerson, PA-C
• Casey Michelle Perkins
• Clint Perkins
• Crystal Perkins, MD

• Periodontics in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Periodontics in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.