Individual provider Active NPI

Arnold Sconion II, DDS

  • Dentist
  • Johns Creek, GA
National Provider Identifier
1770632366
Registry record updated Nov 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13688 Issued in GA
Practice address
10305 Medlock Bridge Rd
Suite B3
Johns Creek, GA 30097-5996
Phone
(770) 418-4939
Fax
(770) 418-9394
NPI assigned
Jan 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019-027231 IL
Dentist 122300000X 13688 GA Primary

Addresses

Primary practice location

10305 Medlock Bridge Rd
Suite B3
Johns Creek, GA 30097-5996

Mailing address

10305 Medlock Bridge Rd
Suite B3
Johns Creek, GA 30097-5996
Phone (770) 418-4939

Other identifiers 1

IdentifierTypeStateIssuer
019-027231OtherILLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170126002549 GA Order and Referring Only - DentistPractitioner - Dentist 5698057651

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-027231ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288828800000",
    "number": "1770632366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10305 MEDLOCK BRIDGE RD",
            "address_2": "SUITE B3",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300975996",
            "telephone_number": "770-418-4939",
            "fax_number": "770-418-9394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10305 MEDLOCK BRIDGE RD",
            "address_2": "SUITE B3",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300975996",
            "telephone_number": "770-418-4939",
            "fax_number": "770-418-9394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCONION",
        "first_name": "ARNOLD",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2010-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-027231",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "13688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "019-027231",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

Verify at the official NPI Registry.