Jordan Alexander Reznik, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D015858 Issued in GA

Practice address

236 Perimeter Center Pkwy NE Ste C-30
Atlanta, GA 30346-1402

Phone

(404) 625-3009

NPI assigned

May 13, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Peach Dental LLC

  • Dental Clinic/Center
  • Atlanta, GA
  • NPI 1528672417
  NPD Authorized official

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598745600000",
    "number": "1417513730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 STEWART DR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421907",
            "telephone_number": "404-406-1251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 PERIMETER CENTER PKWY NE STE C-30",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303461402",
            "telephone_number": "404-625-3009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Augusta University The Dental College Of Georgia",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309120001",
            "country_code": "US",
            "telephone_number": "706-721-2251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REZNIK",
        "first_name": "JORDAN",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-13",
        "last_updated": "2020-08-30",
        "certification_date": "2020-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": "DN015858",
            "primary": false
        },
        {
            "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": "D015858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anahita Rezaee
• Sanaz Rezaei, LPC
• Alex A Rezai
• Melanie Rezaie, PT, DPT
• David Alan Reznik, D.D.S.
• Olivia Reznik
• Amir Rezvan, M.D.,M.S.
• RH Eyes Inc
• Rha Health Services Ga LLC
• Rha Health Services Inc

• General Practice Dentistry in Atlanta, GA
• Providers in Atlanta, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2020; 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.