Organization Active NPI

Ga Southern Dental PPO

Doing business as Robinson Family Dentistry

  • Dentist
  • Hahira, GA
National Provider Identifier
1346076122
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
GA SOUTHERN DENTAL PPO
Doing business as
Robinson Family Dentistry
Practice address
950 Ga Highway 122 W
Hahira, GA 31632-1061
Phone
(229) 588-8858
NPI assigned
Sep 10, 2024
Last updated
May 1, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
GA SOUTHERN DENTAL PPOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Authorized official

Name
Erika Melissa Menjivar
Title
Sr. Credentialing Specialist
Phone
(469) 596-6137

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X Primary

Addresses

Primary practice location

950 Ga Highway 122 W
Hahira, GA 31632-1061

Mailing address

5830 Granite Pkwy Ste 780
Plano, TX 75024-6775
Phone (469) 596-6137

Other names 1

  • Robinson Family Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ga Sothern Dental PPO7 organizations share this tax ID, including this one
Part of
Ga Sothern Dental PPO

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

950 GA Highway 122 W
Hahira, GA 31632
Phone (229) 794-3003

NPI Registry JSON

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1346076122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5830 GRANITE PKWY STE 780",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750246775",
            "telephone_number": "469-596-6137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 GA HIGHWAY 122 W",
            "city": "HAHIRA",
            "state": "GA",
            "postal_code": "316321061",
            "telephone_number": "229-588-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GA SOUTHERN DENTAL PPO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GA SOUTHERN DENTAL PPO",
        "enumeration_date": "2024-09-10",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "MENJIVAR",
        "authorized_official_first_name": "ERIKA",
        "authorized_official_middle_name": "MELISSA",
        "authorized_official_title_or_position": "SR. CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "469-596-6137"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Robinson Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Robinson Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hahira, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.