NPIMap

Organization Active NPI

Nukoa Family Dentistry

  • General Practice Dentistry
  • Duluth, GA
National Provider Identifier
1265722219
Registry record updated Apr 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN012668 Issued in GA
Legal business name
NUKOA FAMILY DENTISTRY
Practice address
3705 Old Norcross Rd
Suite 300
Duluth, GA 30096-4335
Phone
(770) 813-0777
Fax
(770) 813-1023
NPI assigned
Apr 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2011

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

Authorized official

Name
Jonathan Hwang
Title
DMD
Phone
(770) 813-0777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN012668 GA Primary

Addresses

Primary practice location

3705 Old Norcross Rd
Suite 300
Duluth, GA 30096-4335

Mailing address

3705 Old Norcross Rd
Suite 300
Duluth, GA 30096-4335
Phone (770) 813-0777

Other identifiers 1

IdentifierTypeStateIssuer
626075029AMedicaidGA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1302566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302566400000",
    "number": "1265722219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 OLD NORCROSS RD",
            "address_2": "SUITE 300",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964335",
            "telephone_number": "770-813-0777",
            "fax_number": "770-813-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 OLD NORCROSS RD",
            "address_2": "SUITE 300",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964335",
            "telephone_number": "770-813-0777",
            "fax_number": "770-813-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUKOA FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-12",
        "last_updated": "2011-04-12",
        "status": "A",
        "authorized_official_last_name": "HWANG",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "DMD",
        "authorized_official_telephone_number": "770-813-0777"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "626075029A",
            "state": "GA"
        }
    ],
    "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 Apr 12, 2011; 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.