Active NPI
Susan Podray, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Cumming, GA
National Provider Identifier
1356579718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DN014467
- Practice address
- 3195 Trammel Rd
Suite 400
Cumming, GA 30041-1335 - Phone
- (678) 787-3863
- NPI assigned
- Jun 24, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS037892 | PA | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DN014467 | GA | Primary |
Addresses
Primary practice location
3195 Trammel Rd
Suite 400
Cumming, GA 30041-1335
Mailing address
3195 Trammel Rd
Suite 400
Cumming, GA 30041-1335
Phone (678) 787-3863
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS037892 | PA | MD | Dentist |
| DN014467 | GA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358985600000",
"number": "1356579718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3195 TRAMMEL RD",
"address_2": "SUITE 400",
"city": "CUMMING",
"state": "GA",
"postal_code": "300411335",
"telephone_number": "678-787-3863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3195 TRAMMEL RD",
"address_2": "SUITE 400",
"city": "CUMMING",
"state": "GA",
"postal_code": "300411335",
"telephone_number": "678-787-3863"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PODRAY",
"first_name": "SUSAN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-24",
"last_updated": "2013-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS037892",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "GA",
"license": "DN014467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cumming, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.