Micah Randal Elloway, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN123691 Issued in GA

Practice address

9164 Dr M L King Jr Ave
Covington, GA 30014-8710

Phone

(770) 784-7030

NPI assigned

Jun 27, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Noura Elloway RDH Randal Elloway DDS Corp

  • General Practice Dentistry
  • Red Bluff, CA
  • NPI 1790400679
  NPD
• Professional Dental Alliance of Covington, LLC

  • Dentist
  • Covington, GA
  • NPI 1629537626
  NPD (past)
• Travis E Hampton, DMD, PC

  • Dentist
  • Covington, GA
  • NPI 1881259109
  NPD (past)
• Sleep Impressions, LLC

  • Specialist
  • Saint Louis, MO
  • NPI 1134547912
  NPD (past)

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1285310813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2426 S MAIN ST",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960804337",
            "telephone_number": "530-527-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9164 DR M L KING JR AVE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300148710",
            "telephone_number": "770-784-7030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2426 S Main St",
            "address_purpose": "LOCATION",
            "city": "Red Bluff",
            "state": "CA",
            "postal_code": "960804337",
            "country_code": "US",
            "telephone_number": "530-527-6777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLOWAY",
        "first_name": "MICAH",
        "middle_name": "RANDAL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-27",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "108894",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN123691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Effortlessly Flawless LLC
• John R Ehret, M.D.
• Ejb Adult Day Care, Inc
• Kalaimani Elango, MD
• Susan Gale Eleazer, PA-C
• Eloniyo Global
• Carrie Lucinda Elrod, PH.D.
• Emerge Pediatric Therapy Services, LLC
• Emory Chiropractic Clinic
• Rondie L. Ervin, M.D.

• General Practice Dentistry in Covington, GA
• Providers in Covington, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; 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.