NPIMap

Organization Active NPI

Atlanta Endodontic Group PC

Doing business as McDonough Endodontic Center

  • Endodontics
  • McDonough, GA
National Provider Identifier
1689961229
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN013945 Issued in GA
Legal business name
ATLANTA ENDODONTIC GROUP PC
Doing business as
McDonough Endodontic Center
Practice address
1705 Hwy 20 W
Suite 200
McDonough, GA 30253
Phone
(770) 954-8672
Fax
(770) 954-0074
NPI assigned
Jul 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Authorized official

Name
Dr. Rolin Desir, DDSNPI 1457589335
Title
Endodontist / Owner
Phone
(770) 954-0072

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X DN013945 GA Primary

Addresses

Primary practice location

1705 Hwy 20 W
Suite 200
McDonough, GA 30253

Mailing address

1705 Hwy 20 W
Suite 200
McDonough, GA 30253
Phone (770) 954-0072

Other names 1

  • McDonough Endodontic Center Doing business as

National Provider Directory

National Provider Directory

Locations

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

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": "1309737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649376000000",
    "number": "1689961229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 HWY 20 W",
            "address_2": "SUITE 200",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "30253",
            "telephone_number": "770-954-0072",
            "fax_number": "770-954-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 HWY 20 W",
            "address_2": "SUITE 200",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "30253",
            "telephone_number": "770-954-8672",
            "fax_number": "770-954-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA ENDODONTIC GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-04",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A",
        "authorized_official_last_name": "DESIR",
        "authorized_official_first_name": "ROLIN",
        "authorized_official_title_or_position": "ENDODONTIST / OWNER",
        "authorized_official_telephone_number": "770-954-0072",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "GA",
            "license": "DN013945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McDonough Endodontic Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "McDonough Endodontic 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 Apr 8, 2022; 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.