Mundy Mill Dental, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MUNDY MILL DENTAL, PC

Practice address

4328 Mundy Mill Rd
Oakwood, GA 30566-2518

Phone

(770) 534-3350

Fax

(770) 534-5718

NPI assigned

Jan 3, 2019

Last updated

Jan 3, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Leola M Ramsey

Title

Office Manager

Phone

(770) 534-3350

Specialties & licenses 1

Addresses

Other names 1

• Michael K. Martin, DDS Former legal business name

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

{
    "created_epoch": "1546473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546473600000",
    "number": "1689147522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 329",
            "city": "OAKWOOD",
            "state": "GA",
            "postal_code": "305660006",
            "telephone_number": "770-534-3350",
            "fax_number": "770-534-5718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4328 MUNDY MILL RD",
            "city": "OAKWOOD",
            "state": "GA",
            "postal_code": "305662518",
            "telephone_number": "770-534-3350",
            "fax_number": "770-534-5718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNDY MILL DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-03",
        "last_updated": "2019-01-03",
        "status": "A",
        "authorized_official_last_name": "RAMSEY",
        "authorized_official_first_name": "LEOLA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-534-3350"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael K. Martin, DDS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Elizabeth Barnes Mixson, M.D.
• Khushbu Mody
• Alisha Denise Moore, NP
• Whitney Hope Moore, PHARMD
• Susan S Moua, FNP
• Michelle Johnson Nastav, FNP-BC
• Nega Respiratory
• Elizabeth Michelle Ngo, LMFT
• Isabel Nogues, PA--C
• North Point Lighthouse Counseling, LLC

• General Practice Dentistry in Oakwood, GA
• Providers in Oakwood, 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 Jan 3, 2019; 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.