Organization Active NPI

Imagix 1 Dental

  • Dentist
  • Alpharetta, GA
National Provider Identifier
1255436994
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
009491 Issued in GA
Legal business name
IMAGIX 1 DENTAL
Practice address
10945 State Bridge Road
402
Alpharetta, GA 30022-8164
Phone
(770) 569-0529
NPI assigned
Sep 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Eugene Witkin, DDS
Title
Dentist/Owner
Phone
(770) 569-0529

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 009491 GA Primary

Addresses

Primary practice location

10945 State Bridge Road
402
Alpharetta, GA 30022-8164

Mailing address

10945 State Bridge Road
402
Alpharetta, GA 30022-8164
Phone (770) 569-0529

National Provider Directory

National Provider Directory

Locations

10945 State Bridge Rd
Ste 402
Johns Creek, GA 30022
Phone (770) 569-0529

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255436994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10945 STATE BRIDGE ROAD",
            "address_2": "402",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300228164",
            "telephone_number": "770-569-0529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10945 STATE BRIDGE ROAD",
            "address_2": "402",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300228164",
            "telephone_number": "770-569-0529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGIX 1 DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WITKIN",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "770-569-0529",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "009491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.