Glen C McIntosh D.D.S., P.C.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

GLEN C MCINTOSH D.D.S., P.C.

Practice address

3400 McClure Bridge Road
Building G Suite B
Duluth, GA 30096

Phone

(770) 476-8576

Fax

(770) 623-9714

NPI assigned

Jan 30, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Glen C McIntosh, D.D.S.

Title

President

Phone

(770) 476-8576

Specialties & licenses 1

Addresses

Other names 1

• North Georgia Oral Surgery & Dental Implants Doing business as

Locations

Practitioners 1

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

• Ramani Gowducheruvu, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Duluth, GA
  • NPI 1346382678
  NPD (past)

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201651200000",
    "number": "1356528558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 MCCLURE BRIDGE ROAD",
            "address_2": "BUILDING G SUITE B",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30096",
            "telephone_number": "770-476-8576",
            "fax_number": "770-623-9714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 MCCLURE BRIDGE ROAD",
            "address_2": "BUILDING G SUITE B",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30096",
            "telephone_number": "770-476-8576",
            "fax_number": "770-623-9714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN C MCINTOSH D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-30",
        "last_updated": "2008-01-30",
        "status": "A",
        "authorized_official_last_name": "MCINTOSH",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-476-8576",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Georgia Oral Surgery & Dental Implants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gim Enterprises LLC
• Stephanie E. Ginn, OTR
• Megan Glasgow
• Laura Dunning Glazebrook, PT, DPT
• Jasmine Gleaton
• Tujuana C Glenn Olajide, R.N., N.P.
• Global Dental Care, LLC
• Global Dental Care, LLC
• Glory Consulting Inc
• Gabrielle Lina Going, DMD

• Oral and Maxillofacial Surgery (Dentist) in Duluth, GA
• Providers in Duluth, GA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; 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.