Individual provider Active NPI

Manasi Jagdish Pai, D.M.D.

  • Dentist
  • Johns Creek, GA
National Provider Identifier
1780893016
Registry record updated Jul 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN012957 Issued in GA
Practice address
11585 Jones Bridge Rd
Suite 710
Johns Creek, GA 30022-8129
Phone
(404) 937-3535
NPI assigned
May 22, 2007
Last updated
Jul 30, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN012957 GA Primary

Addresses

Primary practice location

11585 Jones Bridge Rd
Suite 710
Johns Creek, GA 30022-8129

Mailing address

5302 Spalding Mill PL
Norcross, GA 30092-7609

Other identifiers 1

IdentifierTypeStateIssuer
627489811DMedicaidGA

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
I20150615001059 GA Order and Referring Only - DentistPractitioner - Dentist 5092026294

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pai Dental, P.C. Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406678400000",
    "number": "1780893016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5302 SPALDING MILL PL",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300927609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11585 JONES BRIDGE RD",
            "address_2": "SUITE 710",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300228129",
            "telephone_number": "404-937-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAI",
        "first_name": "MANASI",
        "middle_name": "JAGDISH",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2014-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN012957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "627489811D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

Verify at the official NPI Registry.