East Crogan Dental Group PC

Primary specialty

DentistTaxonomy code 122300000X

License

DN013248 Issued in GA

Legal business name

EAST CROGAN DENTAL GROUP PC

Practice address

168 E Crogan St
Lawrenceville, GA 30046-4950

Phone

(678) 407-2803

NPI assigned

May 20, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Marie Dominique Saturne, DMD

Title

Owner

Phone

(678) 407-2803

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432080000000",
    "number": "1568841856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1173",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300461173",
            "telephone_number": "678-407-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 E CROGAN ST",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464950",
            "telephone_number": "678-407-2803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST CROGAN DENTAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-20",
        "last_updated": "2015-05-20",
        "status": "A",
        "authorized_official_last_name": "SATURNE",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "DOMINIQUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-407-2803",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN013248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "856863952A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Lawrenceville, GA
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• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; 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.