Individual provider Active NPI

James Nathaniel Raley, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Duluth, GA
National Provider Identifier
1245691369
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DN015183 Issued in GA
Practice address
3415 Duluth Highway 120
Duluth, GA 30096-3354
Phone
(770) 623-8520
NPI assigned
Mar 16, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DN015183 GA Primary

Addresses

Primary practice location

3415 Duluth Highway 120
Duluth, GA 30096-3354

Mailing address

3415 Duluth Highway 120
Duluth, GA 30096-3354

Other practice location 1

1430 John Wesley Gilbert Dr
Augusta, GA 30912-0001
Phone (706) 721-2371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN015183GAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ga Specialty Dental Services II, PC Orthodontics and Dentofacial Orthopedics CurrentSince Dec 12, 2021 Accepting new patients
Ga Specialty Dental Services II, PC Orthodontics and Dentofacial Orthopedics CurrentSince Mar 3, 2024 Accepting new patients

Locations

3415 Duluth Highway 120
Duluth, GA 30096
Phone (770) 476-2400

3415 Duluth Highway 120
Ste 2
Duluth, GA 30096
Phone (770) 623-8520

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1245691369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 DULUTH HIGHWAY 120",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300963354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 DULUTH HIGHWAY 120",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300963354",
            "telephone_number": "770-623-8520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1430 John Wesley Gilbert Dr",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309120001",
            "country_code": "US",
            "telephone_number": "706-721-2371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RALEY",
        "first_name": "JAMES",
        "middle_name": "NATHANIEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-16",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": "DN015183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 19, 2019; 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.