Individual provider Active NPI

Mirela Huccheva, DMD

  • General Practice Dentistry
  • Stone Mountain, GA
National Provider Identifier
1730731100
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN015880 Issued in GA
Practice address
5500 Lilburn Stone Mountain Rd Ste a
Stone Mountain, GA 30087-2873
Phone
(770) 923-5500
Fax
(770) 559-9295
NPI assigned
Jul 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

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 DN015880 GA Primary

Addresses

Primary practice location

5500 Lilburn Stone Mountain Rd Ste a
Stone Mountain, GA 30087-2873

Mailing address

5500 Lilburn Stone Mountain Rd Ste a
Stone Mountain, GA 30087-2873
Phone (770) 923-5500

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL office@smokerisedental.com Direct

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
DN015880GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Peachtree Smiles II PC Past Accepting new patients
Midtown Smile Center Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1730731100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 LILBURN STONE MOUNTAIN RD STE A",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300872873",
            "telephone_number": "770-923-5500",
            "fax_number": "770-559-9295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 LILBURN STONE MOUNTAIN RD STE A",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300872873",
            "telephone_number": "770-923-5500",
            "fax_number": "770-559-9295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUCCHEVA",
        "first_name": "MIRELA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "office@smokerisedental.com",
            "affiliation": "N",
            "endpointDescription": "Secure Office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email Secure",
            "address_1": "5500 Lilburn Stone Mountain Rd Ste A",
            "city": "Stone Mountain",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300872873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.