Individual provider Active NPI

Paul Dennis Nagode, DDS

  • Dentist
  • Atlanta, GA
National Provider Identifier
1235224304
Registry record updated Jan 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN 008067 Issued in GA
Practice address
6075 Lake Forrest Dr
Suite 100
Atlanta, GA 30328-3845
Phone
(404) 303-1199
Fax
(404) 303-1667
NPI assigned
Oct 4, 2006
Last updated
Jan 31, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN 008067 GA Primary

Addresses

Primary practice location

6075 Lake Forrest Dr
Suite 100
Atlanta, GA 30328-3845

Mailing address

6075 Lake Forrest Dr
Suite 100
Atlanta, GA 30328-3845
Phone (404) 303-1199

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120928000429 GA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3971752387

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 008067GAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Paul D Nagode DDS PC Dentist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327968000000",
    "number": "1235224304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6075 LAKE FORREST DR",
            "address_2": "SUITE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303283845",
            "telephone_number": "404-303-1199",
            "fax_number": "404-303-1667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6075 LAKE FORREST DR",
            "address_2": "SUITE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303283845",
            "telephone_number": "404-303-1199",
            "fax_number": "404-303-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGODE",
        "first_name": "PAUL",
        "middle_name": "DENNIS",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2012-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN 008067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.