Organization Active NPI

Richard E. Paul DMD PC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • McDonough, GA
National Provider Identifier
1346473220
Registry record updated Mar 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
Legal business name
RICHARD E. PAUL DMD PC
Practice address
2340 Patrick Henry Pkwy
Suite 100
McDonough, GA 30253-4216
Phone
(770) 474-1260
Fax
(770) 474-9395
NPI assigned
Aug 26, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2020

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

Authorized official

Name
Dr. Richard Eric Paul, DMDNPI 1134125248
Title
President
Phone
(770) 474-1260

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 204E00000X Primary

Addresses

Primary practice location

2340 Patrick Henry Pkwy
Suite 100
McDonough, GA 30253-4216

Mailing address

2340 Patrick Henry Pkwy
Suite 100
McDonough, GA 30253-4216
Phone (770) 474-1260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091023000511 GA Part B Supplier - Clinic/Group Practice 1456498468 Receives reassigned benefits from 1 practitioner
Practice locations: McDonough, GA

National Provider Directory

National Provider Directory

Locations

227 S 10th St
Griffin, GA 30224
Phone (770) 229-8255

2340 Patrick Henry Pkwy
Ste 100
McDonough, GA 30253
Phone (770) 474-1260

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585526400000",
    "number": "1346473220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 PATRICK HENRY PKWY",
            "address_2": "SUITE 100",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534216",
            "telephone_number": "770-474-1260",
            "fax_number": "770-474-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 PATRICK HENRY PKWY",
            "address_2": "SUITE 100",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534216",
            "telephone_number": "770-474-1260",
            "fax_number": "770-474-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD E. PAUL DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-26",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A",
        "authorized_official_last_name": "PAUL",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-474-1260",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.