Brian Sherald Deas, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11687 Issued in GA

Practice address

6095 Professional Pkwy
Suite B-103
Douglasville, GA 30134-5607

Phone

(770) 577-5727

Fax

(770) 577-7542

NPI assigned

Nov 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649341306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6095 PROFESSIONAL PKWY",
            "address_2": "SUITE B-103",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345607",
            "telephone_number": "770-577-5727",
            "fax_number": "770-577-7542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6095 PROFESSIONAL PKWY",
            "address_2": "SUITE B-103",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345607",
            "telephone_number": "770-577-5727",
            "fax_number": "770-577-7542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAS",
        "first_name": "BRIAN",
        "middle_name": "SHERALD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "11687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corelle Davis, LCSW
• Sean Germaine Davis, M.D.
• Naga Ratnakar Davuluri, M.D.
• Jennifer Jordan Dawe, NP-C
• DDF Care
• Jamaine Delrosario, RN
• Dennis L. Herendeen, PH.D., P.C.
• Gerald Jerome Dennis II
• Kaitlyn Denny, RBT
• Dentistry Management Services LLC

• General Practice Dentistry in Douglasville, GA
• Providers in Douglasville, 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 8, 2007; 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.