Paul S Ahn, D.D.S.

Key facts

NPI

1275727596

Entity type

Individual (NPI type 1)

Primary specialty

General Practice Dentistry 1223G0001X

License

DN015817 (GA)

Practice address

3885 Mundy Mill Rd Ste 116
Oakwood, GA 30566-3432

Phone

(470) 577-9777

NPI assigned

Aug 29, 2007

Sex

Male

Sole proprietor

No

Organizations & group practices 1

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.

• Split Rock Dental Associates, P.a. General Practice Dentistry · Edison, NJ · NPI 1013120864
  NPD (past) GENERAL PRACTICE

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 23, 2026.

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1275727596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3885 MUNDY MILL RD STE 116",
            "city": "OAKWOOD",
            "state": "GA",
            "postal_code": "305663432",
            "telephone_number": "470-577-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3885 MUNDY MILL RD STE 116",
            "city": "OAKWOOD",
            "state": "GA",
            "postal_code": "305663432",
            "telephone_number": "470-577-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHN",
        "first_name": "PAUL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-29",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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