Active NPI
Brock J Pumphrey I, DMD
- Periodontics
- Atlanta, GA
National Provider Identifier
1306188156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DN014582
- Practice address
- 999 Peachtree St NE Ste 710
Atlanta, GA 30309-3964 - Phone
- (404) 876-4867
- NPI assigned
- Mar 20, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DN014582 | GA | Primary |
Addresses
Primary practice location
999 Peachtree St NE Ste 710
Atlanta, GA 30309-3964
Mailing address
999 Peachtree St NE Ste 710
Atlanta, GA 30309-3964
Phone (404) 876-4867
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN014582 | GA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512518400000",
"number": "1306188156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "999 PEACHTREE ST NE STE 710",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303093964",
"telephone_number": "404-876-4867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "999 PEACHTREE ST NE STE 710",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303093964",
"telephone_number": "404-876-4867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUMPHREY",
"first_name": "BROCK",
"middle_name": "J",
"name_prefix": "Dr.",
"name_suffix": "I",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-03-20",
"last_updated": "2017-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "GA",
"license": "DN014582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.