Individual provider Active NPI

Amesha Monique Hurt, DDS

  • General Practice Dentistry
  • Sandy Springs, GA
National Provider Identifier
1407906993
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN013971 Issued in GA
Practice address
2090 Dunwoody Club Dr Ste 105
Sandy Springs, GA 30350-5406
Phone
(770) 831-0559
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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 DN013971 GA Primary

Addresses

Primary practice location

2090 Dunwoody Club Dr Ste 105
Sandy Springs, GA 30350-5406

Mailing address

2090 Dunwoody Club Dr Ste 105
Sandy Springs, GA 30350-5406
Phone (770) 998-0111

Other names 1

  • Amesha Monique Edwards Former name

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
I20160923001402 GA Order and Referring Only - DentistPractitioner - Dentist 4587951207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN013971GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Lanier Smiles Past Accepting new patients
Jett Ferry Dental Group, PC General Practice PastSince Dec 9, 2019 Accepting new patients

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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1407906993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 DUNWOODY CLUB DR STE 105",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303505406",
            "telephone_number": "770-998-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 DUNWOODY CLUB DR STE 105",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303505406",
            "telephone_number": "770-831-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURT",
        "first_name": "AMESHA",
        "middle_name": "MONIQUE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMESHA",
            "last_name": "EDWARDS",
            "middle_name": "MONIQUE",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sandy Springs, GA

Sources for this page

Verify at the official NPI Registry.