Active NPI
Morgan T Fordham, DMD
- General Practice Dentistry
- Griffin, GA
National Provider Identifier
1669526943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 8763
- Practice address
- 317 S Hill St
Griffin, GA 30224-4223 - Phone
- (770) 227-1865
- Fax
- (770) 227-1920
- NPI assigned
- Jan 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 8763 | GA | Primary |
Addresses
Primary practice location
317 S Hill St
Griffin, GA 30224-4223
Mailing address
317 S Hill St
Griffin, GA 30224-4223
Phone (770) 227-1865
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8763 | GA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669526943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "317 S HILL ST",
"city": "GRIFFIN",
"state": "GA",
"postal_code": "302244223",
"telephone_number": "770-227-1865",
"fax_number": "770-227-1920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "317 S HILL ST",
"city": "GRIFFIN",
"state": "GA",
"postal_code": "302244223",
"telephone_number": "770-227-1865",
"fax_number": "770-227-1920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORDHAM",
"first_name": "MORGAN",
"middle_name": "T",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "8763",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Griffin, GA
Sources for this page
- 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.