Alvin Jerome Rattle Jr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN122656 Issued in GA

Practice address

209 Creekstone RDG
Woodstock, GA 30188-3744

Phone

(770) 928-0871

NPI assigned

May 18, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Mission Dental Mobile LLC

  dba Miles of Smiles

  • Dentist
  • Bessemer, AL
  • NPI 1205694932
  NPD (past)

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1346814092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 CREEKSTONE RDG",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301883744",
            "telephone_number": "225-573-4763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 CREEKSTONE RDG",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301883744",
            "telephone_number": "770-928-0871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATTLE",
        "first_name": "ALVIN",
        "middle_name": "JEROME",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-18",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "D-0006948-C1",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "7212",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN122656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naveen T Raj, D.O
• Julie Taylor Rambo, MS, RD, LD
• Emily J Ramirez, MSW
• Brooke Randolph, CCC-SLP
• Donna W. Ratliff, EDS.,LPC,NCC
• Jonathan Heath Raughton, LCSW
• Rausch Family Practice
• Judith T Rausch, M.D.
• Christopher Lee Rautenstrauch, DMD
• Brijen Raval

• General Practice Dentistry in Woodstock, GA
• Providers in Woodstock, 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 Oct 4, 2022; 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.