Specialty Center for Periodontics & Dental Implants Inc

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

SPECIALTY CENTER FOR PERIODONTICS & DENTAL IMPLANTS INC

Practice address

3655 Highway 5 Ste 102
Douglasville, GA 30135-6936

Phone

(770) 949-7753

NPI assigned

Sep 7, 2026

Organization subpart

No

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

Authorized official

Name

Michaela Muniz

Title

VP, Payor Relations

Phone

(469) 324-3242

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1788739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788739200000",
    "number": "1669381356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3655 HIGHWAY 5 STE 102",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301356936",
            "telephone_number": "770-949-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3655 HIGHWAY 5 STE 102",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301356936",
            "telephone_number": "770-949-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY CENTER FOR PERIODONTICS & DENTAL IMPLANTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-07",
        "last_updated": "2026-09-07",
        "certification_date": "2026-09-07",
        "status": "A",
        "authorized_official_last_name": "MUNIZ",
        "authorized_official_first_name": "MICHAELA",
        "authorized_official_title_or_position": "VP, PAYOR RELATIONS",
        "authorized_official_telephone_number": "469-324-3242"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.