NPIMap

Organization Active NPI

Soh of Georgia Ozf, PC

Doing business as McDonough Endodonic Center

  • Endodontics
  • McDonough, GA
National Provider Identifier
1659054641
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
SOH OF GEORGIA OZF, PC
Doing business as
McDonough Endodonic Center
Practice address
1705 Highway 20 W Ste 200
McDonough, GA 30253-7683
Phone
(770) 954-8672
NPI assigned
Aug 8, 2023
Last updated
Aug 8, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
SOH OF GEORGIA OZF, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Authorized official

Name
Ashly Sunshine
Title
Credentialing Specialist
Phone
(314) 413-2803

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

1705 Highway 20 W Ste 200
McDonough, GA 30253-7683

Mailing address

1705 Highway 20 W Ste 200
McDonough, GA 30253-7683

Other names 1

  • McDonough Endodonic Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Soh of Georgia Ozf PC2 organizations share this tax ID, including this one
Part of
Soh of Georgia Ozf PC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1705 Highway 20 W
Ste 200
McDonough, GA 30253
Phone (770) 954-8672

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691452800000",
    "number": "1659054641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 HIGHWAY 20 W STE 200",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302537683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 HIGHWAY 20 W STE 200",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302537683",
            "telephone_number": "770-954-8672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOH OF GEORGIA OZF, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOH OF GEORGIA OZF, PC",
        "enumeration_date": "2023-08-08",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A",
        "authorized_official_last_name": "SUNSHINE",
        "authorized_official_first_name": "ASHLY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "314-413-2803"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McDonough Endodonic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; 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.