Individual provider Active NPI

Magdy Attia, D.M.D.

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1245284041
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN012425 Issued in GA
Practice address
30 Warren St
Atlanta, GA 30317
Phone
(404) 370-7360
Fax
(404) 370-7379
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN012425 GA Primary

Addresses

Primary practice location

30 Warren St
Atlanta, GA 30317

Mailing address

720 West Lanier Avenue
Fayetteville, GA 30214
Phone (770) 461-7700

Other identifiers 2

IdentifierTypeStateIssuer
025496141BMedicaidGA
025496141AMedicaidGA

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
I20170501001830 GA Order and Referring Only - DentistPractitioner - Dentist 4082991039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN012425GAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369094400000",
    "number": "1245284041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WEST LANIER AVENUE",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30214",
            "telephone_number": "770-461-7700",
            "fax_number": "770-461-7750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 WARREN ST",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30317",
            "telephone_number": "404-370-7360",
            "fax_number": "404-370-7379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATTIA",
        "first_name": "MAGDY",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2013-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025496141B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025496141A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.