Active NPI
Gary L Nelson, DMD
- Dentist
- Johns Creek, GA
National Provider Identifier
1265720593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN014907
- Practice address
- 9925 Haynes Bridge Rd
Suite 700
Johns Creek, GA 30022-8532 - Phone
- (470) 297-6700
- Fax
- (470) 297-6693
- NPI assigned
- Jul 20, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN014907 | GA | Primary |
Addresses
Primary practice location
9925 Haynes Bridge Rd
Suite 700
Johns Creek, GA 30022-8532
Mailing address
9925 Haynes Bridge Rd
Suite 700
Johns Creek, GA 30022-8532
Phone (470) 297-6700
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN014907 | GA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427673600000",
"number": "1265720593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9925 HAYNES BRIDGE RD",
"address_2": "SUITE 700",
"city": "JOHNS CREEK",
"state": "GA",
"postal_code": "300228532",
"telephone_number": "470-297-6700",
"fax_number": "470-297-6693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9925 HAYNES BRIDGE RD",
"address_2": "SUITE 700",
"city": "JOHNS CREEK",
"state": "GA",
"postal_code": "300228532",
"telephone_number": "470-297-6700",
"fax_number": "470-297-6693"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "GARY",
"middle_name": "L",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-20",
"last_updated": "2015-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "DN014907",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johns Creek, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.