NPIMap

Organization Active NPI

Soh of Georgia Ozf PC

  • Endodontics
  • Conyers, GA
National Provider Identifier
1295202240
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
SOH OF GEORGIA OZF PC
Practice address
1920 Highway 20 SE Ste a
Conyers, GA 30013-2048
Phone
(706) 800-9118
NPI assigned
Oct 29, 2018
Organization subpart
Yes
Parent organization
SOH OF GEORGIA OZF PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Authorized official

Name
Ashly Sunshine
Title
Credentialing Specialist
Phone
(314) 413-2803

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

1920 Highway 20 SE Ste a
Conyers, GA 30013-2048

Mailing address

1422 Elbridge Payne Rd Ste 240
Chesterfield, MO 63017-8544

Other names 1

  • Conyers Endodonic Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Soh of Georgia Ozf PC2 organizations share this tax ID, including this one
Part of
Soh of Georgia Ozf PC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691452800000",
    "number": "1295202240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 ELBRIDGE PAYNE RD STE 240",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630178544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 HIGHWAY 20 SE STE A",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300132048",
            "telephone_number": "706-800-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOH OF GEORGIA OZF PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOH OF GEORGIA OZF PC",
        "enumeration_date": "2018-10-29",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A",
        "authorized_official_last_name": "SUNSHINE",
        "authorized_official_first_name": "ASHLY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "314-413-2803"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Conyers Endodonic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; 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.