Individual provider Active NPI

Alexandra Rae Cabrera, DMD

  • General Practice Dentistry
  • Marietta, GA
National Provider Identifier
1578298352
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN26996 Issued in FL
Practice address
3733 Canton Rd
Marietta, GA 30066-2663
Phone
(770) 926-9914
NPI assigned
Jul 18, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN26996 FL Primary
General Practice Dentistry 1223G0001X DN122921 GA

Addresses

Primary practice location

3733 Canton Rd
Marietta, GA 30066-2663

Mailing address

1810 Hawthorn Ter
Cumming, GA 30041-7640
Phone (727) 836-0682

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
DN26996FLMDGeneral Practice Dentistry
DN122921GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer H Wohlers DDS PC General Practice CurrentSince Jan 29, 2023 Accepting new patients
Todd W Mullikin, DDS, PC Single Specialty PastSince Jan 29, 2023 Accepting new patients

Locations

3733 Canton Rd
Marietta, GA 30066
Phone (770) 926-9914

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1658102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1578298352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 HAWTHORN TER",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417640",
            "telephone_number": "727-836-0682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3733 CANTON RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300662663",
            "telephone_number": "770-926-9914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABRERA",
        "first_name": "ALEXANDRA",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-18",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN26996",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN122921",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.