Fady G Ebid, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN012395 Issued in GA

Practice address

3950 Cobb Pkwy NW
Suite 402
Acworth, GA 30101-9532

Phone

(770) 966-9396

Fax

(770) 966-8774

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Lake Pointe Dental Inc

  • General Practice Dentistry
  • Acworth, GA
  • NPI 1093825028
  NPD (past)
• Lake Pointe Dental Inc

  • General Practice Dentistry
  • Canton, GA
  • NPI 1770929119
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1295845261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6615 HICKORY FLAT HWY",
            "address_2": "STE 100",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301157237",
            "telephone_number": "770-872-0548",
            "fax_number": "770-872-0548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 COBB PKWY NW",
            "address_2": "SUITE 402",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301019532",
            "telephone_number": "770-966-9396",
            "fax_number": "770-966-8774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBID",
        "first_name": "FADY",
        "middle_name": "G",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180312557A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martin Duke, RPT
• Robert Joseph Duke
• Whitni Cox Duncanson, BCBA
• Krysten Butler Duren, D.C.
• Kristen Dyer
• Darra M Edwards, MA, PHARMD, BCPS
• Nicole J Edwards, D.C.
• Tiffany Cecile Edwards
• Elite Glam Society
• Elite Total Wellness, LLC

• General Practice Dentistry in Acworth, GA
• Providers in Acworth, 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 Dec 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.