Individual provider Active NPI

William Bruce Fink, DDS

  • Dentist
  • Woodstock, GA
National Provider Identifier
1700077922
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN011355 Issued in GA
Practice address
1816 Eagle Dr Ste 200-a
Woodstock, GA 30189-8274
Phone
(770) 926-0000
Fax
(770) 818-5850
NPI assigned
Aug 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DNO11355 GA
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DN011355 GA Primary
Public Health Dentistry 1223D0001X DNO11355 GA

Addresses

Primary practice location

1816 Eagle Dr Ste 200-a
Woodstock, GA 30189-8274

Mailing address

106 Gold Leaf CT
Canton, GA 30114-9719
Phone (770) 331-1092

Other practice location 1

2300 Windy Ridge Pkwy SE Unit 220
Atlanta, GA 30339-5665
Phone (770) 214-4252

Other practice location 2

1918 Highway 74 N
Tyrone, GA 30290-1604
Phone (770) 859-9577

Other practice location 3

6001 Professional Pkwy Ste 1030
Douglasville, GA 30134-5634
Phone (404) 274-7335

Other identifiers 3

IdentifierTypeStateIssuer
1255281721OtherGANPI
1700077922OtherGACOMMERCIAL PAYERS
1144589326OtherGANPI

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN011355GAMDDentist
DNO11355GAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1700077922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 GOLD LEAF CT",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301149719",
            "telephone_number": "770-331-1092",
            "fax_number": "770-818-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1816 EAGLE DR STE 200-A",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301898274",
            "telephone_number": "770-926-0000",
            "fax_number": "770-818-5850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 Windy Ridge Pkwy SE Unit 220",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303395665",
            "country_code": "US",
            "telephone_number": "770-214-4252",
            "fax_number": "770-818-5723",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1918 Highway 74 N",
            "address_purpose": "LOCATION",
            "city": "Tyrone",
            "state": "GA",
            "postal_code": "302901604",
            "country_code": "US",
            "telephone_number": "770-859-9577",
            "fax_number": "770-818-5850",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6001 Professional Pkwy Ste 1030",
            "address_purpose": "LOCATION",
            "city": "Douglasville",
            "state": "GA",
            "postal_code": "301345634",
            "country_code": "US",
            "telephone_number": "404-274-7335",
            "fax_number": "770-818-5723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FINK",
        "first_name": "WILLIAM",
        "middle_name": "BRUCE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DNO11355",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN011355",
            "primary": true
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "GA",
            "license": "DNO11355",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1255281721",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL PAYERS",
            "identifier": "1700077922",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1144589326",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; 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.