Individual provider Active NPI

Robert Cudia, D.M.D.

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1700904885
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN011083 Issued in GA
Practice address
2460 Cumberland Pkwy SE
210
Atlanta, GA 30339-4519
Phone
(770) 433-2414
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN011083 GA Primary

Addresses

Primary practice location

2460 Cumberland Pkwy SE
210
Atlanta, GA 30339-4519

Mailing address

1417 Sylvan Cir NE
Atlanta, GA 30319-3423
Phone (404) 262-9968

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

LicenseStateTypeSpecialty
DN011083GAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700904885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 SYLVAN CIR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303193423",
            "telephone_number": "404-262-9968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 CUMBERLAND PKWY SE",
            "address_2": "210",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303394519",
            "telephone_number": "770-433-2414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUDIA",
        "first_name": "ROBERT",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN011083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, 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.

Verify at the official NPI Registry.