Individual provider Active NPI

Joseph Benjamin Newman, DMD

  • General Practice Dentistry
  • Johns Creek, GA
National Provider Identifier
1366068090
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN016071 Issued in GA
Practice address
9570 Nesbit Ferry Rd Ste 103
Johns Creek, GA 30022-6859
Phone
(770) 992-0502
NPI assigned
Jun 18, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN016071 GA Primary

Addresses

Primary practice location

9570 Nesbit Ferry Rd Ste 103
Johns Creek, GA 30022-6859

Mailing address

9570 Nesbit Ferry Rd Ste 103
Alpharetta, GA 30022-6859
Phone (770) 992-0502

Other practice location 1

7840 Hickory Flat Hwy
Woodstock, GA 30188-2099
Phone (770) 479-8654

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

LicenseStateTypeSpecialty
DN016071GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Charles H Dodge DMD PC General Practice CurrentSince Jan 22, 2023 Accepting new patients
Imagix Dental of Hickory Flat LLC Past Accepting new patients

Locations

9570 Nesbit Ferry Rd
Ste 103
Johns Creek, GA 30022
Phone (770) 992-0502

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1592438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1366068090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9570 NESBIT FERRY RD STE 103",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300226859",
            "telephone_number": "770-992-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9570 NESBIT FERRY RD STE 103",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300226859",
            "telephone_number": "770-992-0502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7840 Hickory Flat Hwy",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "GA",
            "postal_code": "301882099",
            "country_code": "US",
            "telephone_number": "770-479-8654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEWMAN",
        "first_name": "JOSEPH",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-18",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN016071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; 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.