Active NPI
Nathan J. Dallas, D.M.D.
- General Practice Dentistry
- Albany, GA
National Provider Identifier
1326242298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 13565
- Practice address
- 2206 Dawson Rd
Albany, GA 31707-3279 - Phone
- (229) 883-1306
- NPI assigned
- Jun 13, 2007
- Last updated
- Feb 8, 2024
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 13565 | GA | Primary |
Addresses
Primary practice location
2206 Dawson Rd
Albany, GA 31707-3279
Mailing address
5100 Grandview Dr
Albany, GA 31721-9422
Phone (229) 573-7122
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13565 | GA | MD | Music Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707350400000",
"number": "1326242298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5100 GRANDVIEW DR",
"city": "ALBANY",
"state": "GA",
"postal_code": "317219422",
"telephone_number": "229-573-7122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2206 DAWSON RD",
"city": "ALBANY",
"state": "GA",
"postal_code": "317073279",
"telephone_number": "229-883-1306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALLAS",
"first_name": "NATHAN",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-13",
"last_updated": "2024-02-08",
"certification_date": "2024-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "13565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.