Individual provider Active NPI

Marie C. Schweinebraten, D.M.D.

  • Periodontics
  • Norcross, GA
National Provider Identifier
1811019144
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
9006 Issued in GA
Practice address
3953 Holcomb Bridge Rd
Suite 100
Norcross, GA 30092-2207
Phone
(770) 446-2640
Fax
(770) 446-6301
NPI assigned
Apr 6, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 9006 GA Primary

Addresses

Primary practice location

3953 Holcomb Bridge Rd
Suite 100
Norcross, GA 30092-2207

Mailing address

3953 Holcomb Bridge Rd
Suite 100
Norcross, GA 30092-2207
Phone (770) 446-2640

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
I20140917001296 GA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1355560749

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9006GAMDPeriodontist

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": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811019144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3953 HOLCOMB BRIDGE RD",
            "address_2": "SUITE 100",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300922207",
            "telephone_number": "770-446-2640",
            "fax_number": "770-446-6301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3953 HOLCOMB BRIDGE RD",
            "address_2": "SUITE 100",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300922207",
            "telephone_number": "770-446-2640",
            "fax_number": "770-446-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWEINEBRATEN",
        "first_name": "MARIE",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "GA",
            "license": "9006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

Verify at the official NPI Registry.