Georgia Grace Rogers, DMD, MPH

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS-028395-L Issued in PA

Practice address

6455 Machine Street
Apg Dental Clinic
Aberdeen Proving Ground, MD 21005

Phone

(410) 278-1795

NPI assigned

Aug 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Georgia Grace Delacruz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1366555609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6455 MACHINE STREET",
            "address_2": "APG DENTAL CLINIC",
            "city": "ABERDEEN PROVING GROUND",
            "state": "MD",
            "postal_code": "21005",
            "telephone_number": "410-278-1795",
            "fax_number": "410-278-5577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6455 MACHINE STREET",
            "address_2": "APG DENTAL CLINIC",
            "city": "ABERDEEN PROVING GROUND",
            "state": "MD",
            "postal_code": "21005",
            "telephone_number": "410-278-1795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "GEORGIA",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "DMD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "PA",
            "license": "DS-028395-L",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS-028395-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GEORGIA",
            "last_name": "DELACRUZ",
            "middle_name": "GRACE",
            "prefix": "DR.",
            "credential": "DMD, MPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tonya Charise Phillips, LCSW-C,LCADC
• Kim Theresa Pierre-Zamora, AUD
• Justice Gerald Sheridan Pilgrim, DDS
• William Arthur Rice, MD, MPH, MHA
• Pamela Diane Ricketts, PHARMD
• Lauretta Yvette Scott
• Michelle Cherie Sedlak, RN
• Jenna Marie Sembrat, OD
• Barbara Wirtz Siskind, M.D.
• Matthew David Sommer, CRNP

• General Practice Dentistry in Aberdeen Proving Ground, MD
• Providers in Aberdeen Proving Ground, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; 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.