Individual provider Active NPI

Elizabeth W Muraya

  • General Practice Dentistry
  • Hiram, GA
National Provider Identifier
1295347748
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN016126-T Issued in GA
Practice address
5218 Jimmy Lee Smith Pkwy Ste 100
Hiram, GA 30141-2747
Phone
(770) 439-1038
NPI assigned
Aug 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11410 TN
General Practice Dentistry 1223G0001X 11410 TN
General Practice Dentistry 1223G0001X DN016126-T GA Primary

Addresses

Primary practice location

5218 Jimmy Lee Smith Pkwy Ste 100
Hiram, GA 30141-2747

Mailing address

2000 View Dr Unit 2201
Woodstock, GA 30189-5355
Phone (678) 678-1821

Other practice location 1

2000 View Dr Unit 2201
Woodstock, GA 30189-5355
Phone (678) 678-1821 ext. 67867

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210212000376 GA Order and Referring Only - DentistPractitioner - Dentist 8921413543

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN016126-TGAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Hiram Dental Group, PC General Practice PastSince Sep 6, 2020 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1295347748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 VIEW DR UNIT 2201",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301895355",
            "telephone_number": "678-678-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5218 JIMMY LEE SMITH PKWY STE 100",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412747",
            "telephone_number": "770-439-1038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 View Dr Unit 2201",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "GA",
            "postal_code": "301895355",
            "country_code": "US",
            "telephone_number": "678-678-1821 x67867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MURAYA",
        "first_name": "ELIZABETH",
        "middle_name": "W",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "11410",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "11410",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN016126-T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hiram, GA

Sources for this page

Verify at the official NPI Registry.