Individual provider Active NPI

Alexandria Jeanette Cobb, DDS

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1407504590
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN122886 Issued in GA
Practice address
1015 Donald Lee Hollowell Pkwy NW
Atlanta, GA 30318-6653
Phone
(404) 523-6571
NPI assigned
Mar 16, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X DN122886 GA Primary

Addresses

Primary practice location

1015 Donald Lee Hollowell Pkwy NW
Atlanta, GA 30318-6653

Mailing address

903 Huff Rd NW Unit 1404
Atlanta, GA 30318-4636
Phone (513) 969-3019

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
DN122886GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
The Good Samaritan Health Center, Inc. CurrentSince Mar 20, 2022 Accepting new patients
Hope First Investments CurrentSince Sep 20, 2022 Accepting new patients

Locations

1015 Donald Lee Hollowell Pkwy NW
Atlanta, GA 30318
Phone (404) 523-6571

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1647388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1407504590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 HUFF RD NW UNIT 1404",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303184636",
            "telephone_number": "513-969-3019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 DONALD LEE HOLLOWELL PKWY NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303186653",
            "telephone_number": "404-523-6571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBB",
        "first_name": "ALEXANDRIA",
        "middle_name": "JEANETTE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-16",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN122886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; 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.