North Georgia Oral and Facial Surgery LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

NORTH GEORGIA ORAL AND FACIAL SURGERY LLC

Practice address

3400 McClure Bridge Rd
BLDG G, Suites B and C
Duluth, GA 30096

Phone

(770) 476-8576

NPI assigned

Apr 16, 2024

Last updated

Apr 16, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ramani Gowducheruvu, DDSNPI 1346382678

Title

Owner-Oral and Maxillofacial Surgeo

Phone

(248) 914-1691

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ramani Gowducheruvu, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Duluth, GA
  • NPI 1346382678
  NPD Authorized official

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

{
    "created_epoch": "1713225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713225600000",
    "number": "1558115485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5198 DINANT DR",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300226532",
            "telephone_number": "248-914-1691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 MCCLURE BRIDGE RD",
            "address_2": "BLDG G, SUITES B AND C",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30096",
            "telephone_number": "770-476-8576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH GEORGIA ORAL AND FACIAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-16",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A",
        "authorized_official_last_name": "GOWDUCHERUVU",
        "authorized_official_first_name": "RAMANI",
        "authorized_official_title_or_position": "OWNER-ORAL AND MAXILLOFACIAL SURGEO",
        "authorized_official_telephone_number": "248-914-1691",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Duluth, GA
• Providers in Duluth, GA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.