Facial Trauma Specialists LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

FACIAL TRAUMA SPECIALISTS LLC

Practice address

2008 Lawrenceville Suwanee Rd
Suwanee, GA 30024-2625

Phone

(678) 905-9066

NPI assigned

Aug 21, 2025

Last updated

Aug 21, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shahrokh Bagheri, DMD MDNPI 1154325587

Title

Owner

Phone

(404) 964-6921

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shahrokh C Bagheri, M.D. D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Marietta, GA
  • NPI 1154325587
  Medicare reassignment NPD Authorized official
• Husain Ali-Khan, M.D. D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Marietta, GA
  • NPI 1962406397
  Medicare reassignment NPD
• Christine Marie Talegaonkar, DMD, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Marietta, GA
  • NPI 1497314454
  Medicare reassignment NPD

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

{
    "created_epoch": "1755734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755734400000",
    "number": "1285512087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 W OAK PKWY STE 111",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300622274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2008 LAWRENCEVILLE SUWANEE RD",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242625",
            "telephone_number": "678-905-9066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACIAL TRAUMA SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-21",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A",
        "authorized_official_last_name": "BAGHERI",
        "authorized_official_first_name": "SHAHROKH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-964-6921",
        "authorized_official_credential": "DMD MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.