Individual provider Active NPI

Clinton David Baugham, DMD

  • General Practice Dentistry
  • Peachtree Corners, GA
National Provider Identifier
1295170652
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN014793 Issued in GA
Practice address
3961 Holcomb Bridge Rd Ste 100
Peachtree Corners, GA 30092-5298
Phone
(770) 449-0202
Fax
(770) 502-6772
NPI assigned
Apr 30, 2013
Last updated
May 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN014793 GA Primary

Addresses

Primary practice location

3961 Holcomb Bridge Rd Ste 100
Peachtree Corners, GA 30092-5298

Mailing address

3961 Holcomb Bridge Rd Ste 100
Peachtree Corners, GA 30092-5298
Phone (770) 449-0202

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

LicenseStateTypeSpecialty
DN014793GAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1295170652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3961 HOLCOMB BRIDGE RD STE 100",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300925298",
            "telephone_number": "770-449-0202",
            "fax_number": "770-502-6772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3961 HOLCOMB BRIDGE RD STE 100",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300925298",
            "telephone_number": "770-449-0202",
            "fax_number": "770-502-6772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUGHAM",
        "first_name": "CLINTON",
        "middle_name": "DAVID",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-30",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN014793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree Corners, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2026; 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.