John Mark Mazzawi, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN011705 Issued in GA

Practice address

2268 East Main Street
Snellville, GA 30078

Phone

(770) 972-4436

Fax

(770) 985-8810

NPI assigned

Oct 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Mark Mazzawi Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mazzawi Family Dentistry, P.C.

  • General Practice Dentistry
  • Snellville, GA
  • NPI 1811020241
  NPD (past) Authorized official

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508956038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 CLAIRMONT RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292710",
            "telephone_number": "770-605-2520",
            "fax_number": "770-985-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2268 EAST MAIN STREET",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "30078",
            "telephone_number": "770-972-4436",
            "fax_number": "770-985-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZAWI",
        "first_name": "JOHN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN011705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARK",
            "last_name": "MAZZAWI",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Virginia Susan Mayo, D.C.
• Deidra L Mays, LPC
• Mazzawi Family Dentistry, P.C.
• Anne Cown Mazzawi, D.D.S.
• James Matt Mazzawi, D.M.D.
• Marty Mazzawi, D.D.S.
• Patrick McAnally, PA-C
• Arlene Babas McCaffrey
• Lee McCann
• Sheila P McCartney, C.R.N.A.

• General Practice Dentistry in Snellville, GA
• Providers in Snellville, 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 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.

Verify at the official NPI Registry.