NPIMap

Organization Active NPI

Jsa Dental Associates McDonough PC

  • General Practice Dentistry
  • McDonough, GA
National Provider Identifier
1356793962
Registry record updated Jul 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN013121 Issued in GA
Legal business name
JSA DENTAL ASSOCIATES MCDONOUGH PC
Practice address
400 McDonough Pkwy
McDonough, GA 30253-8946
Phone
(770) 957-5214
Fax
(770) 957-5215
NPI assigned
Jul 7, 2016
Last updated
Jul 7, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2016

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

Authorized official

Name
Juanita AdkinsNPI 1295845543
Title
Dentist
Phone
(770) 957-5214

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN013121 GA Primary

Addresses

Primary practice location

400 McDonough Pkwy
McDonough, GA 30253-8946

Mailing address

400 McDonough Pkwy
McDonough, GA 30253-8946
Phone (770) 957-5214

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1467849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467849600000",
    "number": "1356793962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MCDONOUGH PKWY",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302538946",
            "telephone_number": "770-957-5214",
            "fax_number": "770-957-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MCDONOUGH PKWY",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302538946",
            "telephone_number": "770-957-5214",
            "fax_number": "770-957-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JSA DENTAL ASSOCIATES MCDONOUGH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-07",
        "last_updated": "2016-07-07",
        "status": "A",
        "authorized_official_last_name": "ADKINS",
        "authorized_official_first_name": "JUANITA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "770-957-5214"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013121",
            "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 Jul 7, 2016; 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.