Individual provider Active NPI

Bhavana Venugopalan, D.M.D.

  • General Practice Dentistry
  • Acworth, GA
National Provider Identifier
1528950813
Registry record updated Jul 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN123862 Issued in GA
Practice address
3384 Cobb Pkwy NW Ste 130
Acworth, GA 30101-8784
Phone
(678) 574-8622
NPI assigned
Jul 19, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2025

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 DN123862 GA Primary

Addresses

Primary practice location

3384 Cobb Pkwy NW Ste 130
Acworth, GA 30101-8784

Mailing address

3483 Winter Chase Dr
Marietta, GA 30062-1221
Phone (305) 877-6352

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
DN123862GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Acworth Smiles Dentistry, PC General Practice PastSince Jul 22, 2025 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1752883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752883200000",
    "number": "1528950813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3483 WINTER CHASE DR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300621221",
            "telephone_number": "305-877-6352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3384 COBB PKWY NW STE 130",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301018784",
            "telephone_number": "678-574-8622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENUGOPALAN",
        "first_name": "BHAVANA",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-19",
        "last_updated": "2025-07-19",
        "certification_date": "2025-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN123862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acworth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2025; 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.