R Jason Neil Bongiovi DMD PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN013085 Issued in GA

Legal business name

R JASON NEIL BONGIOVI DMD PC

Doing business as

Pediatric Dentistry of Forsyth

Practice address

3810 Windemere Parkway
Ste 502
Cumming, GA 30041

Phone

(404) 316-0588

NPI assigned

Feb 11, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Jason Neil Bongiovi, DMD

Title

President

Phone

(404) 316-0588

Specialties & licenses 1

Addresses

Other names 1

• Pediatric Dentistry of Forsyth Doing business as

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234310400000",
    "number": "1356580633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 VERNON GLEN CT",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303385420",
            "telephone_number": "404-316-0588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 WINDEMERE PARKWAY",
            "address_2": "STE 502",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30041",
            "telephone_number": "404-316-0588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R JASON NEIL BONGIOVI DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-11",
        "last_updated": "2009-02-11",
        "status": "A",
        "authorized_official_last_name": "BONGIOVI",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "NEIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-316-0588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN013085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Dentistry of Forsyth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Quantum Healthwork, Inc
• James Quick
• Sergio F Quijano, M.D.
• Kela Quinn, PHARM D
• Hisham Fozi Qutob, M.D.
• Josie Rabbitt, MS, APC
• Rebecca Rabun
• Radiant Axis Ventures LLC
• Hallie Radler, RBT
• David Arnel Ragan, DO MPH

• Pediatric Dentistry in Cumming, GA
• Providers in Cumming, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2009; 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.