Individual provider Active NPI

Robert E Going Jr., DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Conyers, GA
National Provider Identifier
1376651034
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN009552 Issued in GA
Practice address
1463 Klondike Road
Suite C
Conyers, GA 30094
Phone
(770) 483-9692
Fax
(678) 487-1004
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN009552 GA Primary

Addresses

Primary practice location

1463 Klondike Road
Suite C
Conyers, GA 30094

Mailing address

1463 Klondike Road
Suite C
Conyers, GA 30094
Phone (770) 483-9692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110217000307 GA Practitioner - Oral Surgery 3072650142 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9552GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Oral Surgery Associates & Dental Implant Center PC Oral and Maxillofacial Surgery CurrentSince Jul 1, 1986 Accepting new patients
Sentry Anesthesia Management, LLC PastSince Aug 17, 2022 Accepting new patients

Locations

3580 Piedmont Rd NE
Ste 207
Atlanta, GA 30305
Phone (404) 233-5385

1463 Klondike Rd SW
Ste C
Conyers, GA 30094
Phone (770) 483-9692

1463 Klondike Rd SW
Conyers, GA 30094

7135 Floyd St NE
Covington, GA 30014
Phone (770) 787-2444

5243 Snapfinger Woods Dr
Ste 106
Decatur, GA 30035
Phone (404) 233-5385

10930 Crabapple Rd
Ste 160
Roswell, GA 30075
Phone (678) 781-0050

2386 Clower St
Ste F100
Snellville, GA 30078
Phone (770) 979-9500

4915 Lavista Rd
Tucker, GA 30084
Phone (404) 528-3500

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376651034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1463 KLONDIKE ROAD",
            "address_2": "SUITE C",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "30094",
            "telephone_number": "770-483-9692",
            "fax_number": "678-487-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1463 KLONDIKE ROAD",
            "address_2": "SUITE C",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "30094",
            "telephone_number": "770-483-9692",
            "fax_number": "678-487-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOING",
        "first_name": "ROBERT",
        "middle_name": "E",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "DN009552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.