Individual provider Active NPI

Jason Allan Myerson, D.M.D.

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1457549396
Registry record updated Oct 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN013106 Issued in GA
Practice address
3340 Peachtree Rd NE
Suite 1685
Atlanta, GA 30326-1000
Phone
(404) 266-1300
NPI assigned
Oct 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2007

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 DN013106 GA Primary

Addresses

Primary practice location

3340 Peachtree Rd NE
Suite 1685
Atlanta, GA 30326-1000

Mailing address

3340 Peachtree Rd NE
Suite 1685
Atlanta, GA 30326-1000
Phone (404) 266-1300

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
I20150707000075 GA Order and Referring Only - DentistPractitioner - Dentist 2365754223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN013106GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Buckhead Dental Associates, P.C. General Practice Past Accepting new patients

Organizations & group practices 1

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": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191456000000",
    "number": "1457549396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 PEACHTREE RD NE",
            "address_2": "SUITE 1685",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261000",
            "telephone_number": "404-266-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 PEACHTREE RD NE",
            "address_2": "SUITE 1685",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261000",
            "telephone_number": "404-266-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERSON",
        "first_name": "JASON",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-04",
        "last_updated": "2007-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.