Trent Gregory Conner, D.M.D.
Individual provider Active NPI General Practice Dentistry · Dahlonega, GA
NPI 1316080922 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1316080922
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 010669 (GA)
- Practice address
- 235 Rock House Rd
Dahlonega, GA 30533-2709 - Phone
- (706) 864-1275
- Fax
- (706) 864-6954
- NPI assigned
- Feb 14, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160114002161 | GA | Order and Referring Only - Oral Surgery |
0547563181 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010669 | GA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 010669 | GA | Yes |
Addresses
Primary practice location
235 Rock House Rd
Dahlonega, GA 30533-2709
Mailing address
235 Rock House Rd
Dahlonega, GA 30533-2709
Phone (706) 864-1275
Other providers in Dahlonega, GA
- John M Clagett
- Cheryl Beth Clark
- Eddie Sue Cleveland
- Patrick A Conarro
- David James Conaway
- Jennifer S Cook
- Jessica Leanne Cook
- Charlotte Cornelison
- Sara Cowden
- Lisa Ann Cranwell-Bruce
All providers in Dahlonega, GA · General Practice Dentistry in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.