Individual provider Active NPI

Nooredin Nurani, DMD

  • Dentist
  • Dacula, GA
National Provider Identifier
1740366095
Registry record updated Aug 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10916 Issued in GA
Practice address
420 Dacula Rd
Dacula, GA 30019-2128
Phone
(770) 277-0800
NPI assigned
Oct 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10916 GA Primary

Addresses

Primary practice location

420 Dacula Rd
Dacula, GA 30019-2128

Mailing address

1030 Duluth Hwy
Lawrenceville, GA 30043-5215
Phone (770) 995-1957

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

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Cosmetic and Sedation Dentistry CurrentSince Oct 2, 2022 Accepting new patients
CCSD-Dacula, LLC CurrentSince Aug 11, 2019 Accepting new patients

Locations

420 Dacula Rd
Dacula, GA 30019
Phone (770) 277-0800

2100 Riverside Pkwy
Ste 130
Lawrenceville, GA 30043
Phone (770) 822-3400

1030 Duluth Hwy
Lawrenceville, GA 30043
Phone (770) 995-1957

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": "1162166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1740366095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 DULUTH HWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435215",
            "telephone_number": "770-995-1957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 DACULA RD",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300192128",
            "telephone_number": "770-277-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NURANI",
        "first_name": "NOOREDIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-30",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "10916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dacula, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.