Active NPI
Sherwin Douglas Katz, D.M.D.
- General Practice Dentistry
- Macon, GA
National Provider Identifier
1467665182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 9173
- Practice address
- 780 Baconsfield Dr
103
Macon, GA 31211-1442 - Phone
- (478) 743-3023
- Fax
- (478) 742-5509
- NPI assigned
- May 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9173 | GA | Primary |
Addresses
Primary practice location
780 Baconsfield Dr
103
Macon, GA 31211-1442
Mailing address
780 Baconsfield Dr
103
Macon, GA 31211-1442
Phone (478) 743-3023
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9173 | GA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467665182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "780 BACONSFIELD DR",
"address_2": "103",
"city": "MACON",
"state": "GA",
"postal_code": "312111442",
"telephone_number": "478-743-3023",
"fax_number": "478-742-5509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "780 BACONSFIELD DR",
"address_2": "103",
"city": "MACON",
"state": "GA",
"postal_code": "312111442",
"telephone_number": "478-743-3023",
"fax_number": "478-742-5509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KATZ",
"first_name": "SHERWIN",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "9173",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.