Individual provider Active NPI

Ray H. Morgan Jr., D.M.D.

  • General Practice Dentistry
  • Woodstock, GA
National Provider Identifier
1649317033
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10504 Issued in GA
Practice address
120 N Medical Pkwy
Building 200, Suite 100
Woodstock, GA 30189-7062
Phone
(770) 591-7979
Fax
(770) 591-3365
NPI assigned
Feb 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10504 GA Primary

Addresses

Primary practice location

120 N Medical Pkwy
Building 200, Suite 100
Woodstock, GA 30189-7062

Mailing address

120 N Medical Pkwy
Building 200, Suite 100
Woodstock, GA 30189-7062
Phone (770) 591-7979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20140612000501 TN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8224252374

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10504GAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649317033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N MEDICAL PKWY",
            "address_2": "BUILDING 200, SUITE 100",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301897062",
            "telephone_number": "770-591-7979",
            "fax_number": "770-591-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N MEDICAL PKWY",
            "address_2": "BUILDING 200, SUITE 100",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301897062",
            "telephone_number": "770-591-7979",
            "fax_number": "770-591-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "RAY",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "10504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

Verify at the official NPI Registry.