Sadja Gaud-Quintana, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN014695 Issued in GA

Practice address

4373 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2629

Phone

(678) 942-6085

NPI assigned

Apr 27, 2012

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1619235694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3469 FENTON DR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300802392",
            "telephone_number": "787-344-1946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4373 JIMMY LEE SMITH PKWY",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412629",
            "telephone_number": "678-942-6085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2640A Coventry Rd",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309096106",
            "country_code": "US",
            "telephone_number": "787-344-1946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAUD-QUINTANA",
        "first_name": "SADJA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN014695",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Georgia Cancer Specialists I PC
• Georgia CVS Pharmacy LLC (CVS Pharmacy #16739)
• Georgia Pain and Spine Solutions, PC
• Georgian Counseling Associates

• General Practice Dentistry in Hiram, GA
• Providers in Hiram, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.