Alan A Derrick-Griffith, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN013998 Issued in GA

Practice address

2802 Clearwater Ter SE
Conyers, GA 30013-2484

Phone

(470) 595-3540

NPI assigned

Jul 7, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Alan A Griffith Other name

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

State licenses

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.

• Griffin Dental Specialties

  • Periodontics
  • Griffin, GA
  • NPI 1447475959
  NPD (past)

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599436800000",
    "number": "1316100738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2802 CLEARWATER TER SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300132484",
            "telephone_number": "470-595-3540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2802 CLEARWATER TER SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300132484",
            "telephone_number": "470-595-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRICK-GRIFFITH",
        "first_name": "ALAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-07",
        "last_updated": "2020-09-07",
        "certification_date": "2020-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "5375",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALAN",
            "last_name": "GRIFFITH",
            "middle_name": "A",
            "credential": "DMD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Natasha Dennis, RBT
• Sheira Dennis
• Sylvia Denson, PHD
• Dental Wellness Center of Conyers, LLC
• Amit M Deokar, MD, MPH
• Roopal Anil Desa, MD
• Ruchika Agarwal Desai, DDS
• Shakespeare Prince Desir, BABA, MMFT
• Dominique Dessausure, CHIROPRACTOR
• Destined Point Diagnostics

• General Practice Dentistry in Conyers, GA
• Providers in Conyers, 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 Sep 7, 2020; 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.