Individual provider Active NPI

Nancy Gail McLaurin DMD PC, DMD PC

  • Periodontics
  • Atlanta, GA
National Provider Identifier
1629153937
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
011011 Issued in GA
Practice address
5555 Peachtree Dunwoody Rd NE
Suite G-73
Atlanta, GA 30342-1703
Phone
(404) 255-9511
Fax
(404) 256-0901
NPI assigned
Oct 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 011011 GA Primary

Addresses

Primary practice location

5555 Peachtree Dunwoody Rd NE
Suite G-73
Atlanta, GA 30342-1703

Mailing address

5555 Peachtree Dunwoody Rd NE
Suite G-73
Atlanta, GA 30342-1703
Phone (404) 255-9511

Other identifiers 1

IdentifierTypeStateIssuer
00558852BMedicaidGA

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
011011GAMDPeriodontist
11011GAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
N. Gail McLaurin, DMD, PC Periodontics Past Accepting new patients
International Harvest Dentistry Past Accepting new patients

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1629153937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE G-73",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421703",
            "telephone_number": "404-255-9511",
            "fax_number": "404-256-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE G-73",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421703",
            "telephone_number": "404-255-9511",
            "fax_number": "404-256-0901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLAURIN DMD PC",
        "first_name": "NANCY",
        "middle_name": "GAIL",
        "credential": "DMD PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "GA",
            "license": "011011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00558852B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.