Individual provider Active NPI

Amanda Simone Adams, DDS

  • Dentist
  • McDonough, GA
National Provider Identifier
1780425843
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN123955 Issued in GA
Practice address
1867 Jonesboro Rd
McDonough, GA 30253-6099
Phone
(678) 432-0209
NPI assigned
Jun 3, 2024
Last updated
Mar 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 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 DDS-10423 IA
Dentist 122300000X DN30947 FL
Dentist 122300000X DN123955 GA Primary

Addresses

Primary practice location

1867 Jonesboro Rd
McDonough, GA 30253-6099

Mailing address

6551 SW County Road 242
Lake City, FL 32024-4425
Phone (386) 965-3250

Other practice location 1

126 N 10th St
Fort Dodge, IA 50501-3915
Phone (515) 576-6500

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
DN30947FLMDDentist
DN123955GAMDDentist
DDS-10423IAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1780425843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6551 SW COUNTY ROAD 242",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320244425",
            "telephone_number": "386-965-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1867 JONESBORO RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302536099",
            "telephone_number": "678-432-0209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "126 N 10th St",
            "address_purpose": "LOCATION",
            "city": "Fort Dodge",
            "state": "IA",
            "postal_code": "505013915",
            "country_code": "US",
            "telephone_number": "515-576-6500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "AMANDA",
        "middle_name": "SIMONE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-03",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "DDS-10423",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN30947",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN123955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.