Active NPI
Vishant Nath, D.M.D
- Pediatric Dentistry
- Roswell, GA
National Provider Identifier
1396710216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DN013057
- Practice address
- 10930 Crabapple Rd
Suite 106
Roswell, GA 30075-5813 - Phone
- (678) 352-1090
- Fax
- (770) 277-5637
- NPI assigned
- Feb 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DN013057 | GA | Primary |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DN013057 | GA |
Addresses
Primary practice location
10930 Crabapple Rd
Suite 106
Roswell, GA 30075-5813
Mailing address
2012 Ivey Chase Dr
Dacula, GA 30019-7884
Phone (770) 277-5637
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 761564386D | Medicaid | GA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN013057 | GA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477785600000",
"number": "1396710216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2012 IVEY CHASE DR",
"city": "DACULA",
"state": "GA",
"postal_code": "300197884",
"telephone_number": "770-277-5637",
"fax_number": "770-277-5637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10930 CRABAPPLE RD",
"address_2": "SUITE 106",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300755813",
"telephone_number": "678-352-1090",
"fax_number": "770-277-5637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NATH",
"first_name": "VISHANT",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-22",
"last_updated": "2016-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "GA",
"license": "DN013057",
"primary": true
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "GA",
"license": "DN013057",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "761564386D",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Roswell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.