NPIMap

Individual provider Active NPI

Rolin Desir, DDS

  • Endodontics
  • McDonough, GA
National Provider Identifier
1457589335
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN013945 Issued in GA
Practice address
1705 Highway 20 W
Suite 200
McDonough, GA 30253-4547
Phone
(770) 954-8672
Fax
(770) 954-0074
NPI assigned
Jun 30, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DN17864 FL
Endodontics 1223E0200X DN013945 GA Primary

Addresses

Primary practice location

1705 Highway 20 W
Suite 200
McDonough, GA 30253-4547

Mailing address

1705 Highway 20 W Ste 200
McDonough, GA 30253-7683
Phone (770) 954-0072

Other practice location 1

1920 Highway 20 SE
Suite A
Conyers, GA 30013-2048
Phone (470) 486-6025

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
DN17864FLMDEndodontist
DN013945GAMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Endodontic Group PC Endodontics CurrentSince Jun 1, 2021 Accepting new patients
Conyers Endodontic Center PC Endodontics CurrentSince Jul 1, 2020 Accepting new patients
Soh of Georgia Ozf, PC Endodontics CurrentSince Aug 13, 2023 Accepting new patients

Locations

1920 Highway 20 SE
Ste A
Conyers, GA 30013
Phone (470) 486-6025

1705 Highway 20 W
Ste 200
McDonough, GA 30253
Phone (770) 954-8672

Organizations & group practices 3

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": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1457589335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 HIGHWAY 20 W STE 200",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302537683",
            "telephone_number": "770-954-0072",
            "fax_number": "770-954-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 HIGHWAY 20 W",
            "address_2": "SUITE 200",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534547",
            "telephone_number": "770-954-8672",
            "fax_number": "770-954-0074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1920 Highway 20 SE",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Conyers",
            "state": "GA",
            "postal_code": "300132048",
            "country_code": "US",
            "telephone_number": "470-486-6025",
            "fax_number": "470-474-2221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESIR",
        "first_name": "ROLIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN17864",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "GA",
            "license": "DN013945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.