Organization Active NPI

Rejuvenescence Oral & Facial Surgery, Dental Implants, and Cosmetics, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Duluth, GA
National Provider Identifier
1598370454
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
REJUVENESCENCE ORAL & FACIAL SURGERY, DENTAL IMPLANTS, AND COSMETICS, PC
Practice address
3630 Savannah PL Ste 250
Duluth, GA 30096-6394
Phone
(000) 000-0000
NPI assigned
Sep 8, 2020
Last updated
Mar 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Authorized official

Name
Dr. Karin Davis, DMD
Title
Oral Surgeon
Phone
(470) 394-4900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X Primary

Addresses

Primary practice location

3630 Savannah PL Ste 250
Duluth, GA 30096-6394

Mailing address

PO Box 111
Duluth, GA 30096-0002

National Provider Directory

National Provider Directory

Locations

3630 Savannah Pl
Ste 250
Duluth, GA 30096
Phone (770) 343-2111

NPI Registry JSON

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1598370454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 111",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300960002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 SAVANNAH PL STE 250",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300966394",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVENESCENCE ORAL & FACIAL SURGERY, DENTAL IMPLANTS, AND COSMETICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-08",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "KARIN",
        "authorized_official_title_or_position": "ORAL SURGEON",
        "authorized_official_telephone_number": "470-394-4900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.