Roman M Cibirka, DDS
Individual provider Active NPI Prosthodontics · Dawsonville, GA
NPI 1255385696 · NPPES record last updated Jan 13, 2025
Key facts
- NPI
- 1255385696
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Prosthodontics 1223P0700X
- License
- DN011807 (GA)
- Practice address
- 541 Brookwood Dr W
Dawsonville, GA 30534-7563 - Phone
- (706) 564-8174
- Fax
- (706) 721-6778
- NPI assigned
- May 20, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN011807 | GA | MD | Prosthodontist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | DN011807 | GA | Yes |
Addresses
Primary practice location
541 Brookwood Dr W
Dawsonville, GA 30534-7563
Mailing address
541 Brookwood Dr W
Dawsonville, GA 30534-7563
Phone (706) 564-8174
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000812534A | Medicaid | GA | |
| ZG1807 | Medicaid | SC |
Other providers in Dawsonville, GA
- Cherokee Eye Group, Inc
- Chestatee Emergent Medical Care
- Tony A. Chester
- Childrens Dentistry of Dawsenville
- Alexander Stuart Christ
- Mariya Cissell
- Jodi Cofer
- Kelly Lynn Combs
- Commissioner of Roads and Revenue Dawson County
- Comprehensive Internal Medicine at Dawsonville, LLC
All providers in Dawsonville, GA · Prosthodontics in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.