Manoj Maggan, DDS, DAAPM, FICCMO

Primary specialty

DentistTaxonomy code 122300000X

License

11376 Issued in GA

Practice address

3590 Old Milton Pkwy
Alpharetta, GA 30005-4465

Phone

(770) 521-1978

Fax

(770) 521-9936

NPI assigned

Nov 22, 2006

Last updated

May 26, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Peachtree Dental Group

  • General Practice Dentistry
  • Alpharetta, GA
  • NPI 1871703553
  NPD (past) Authorized official
• Forsyth Spinal Rehabilitation Ctr

  • Chiropractor
  • Cumming, GA
  • NPI 1659529873
  NPD (past)

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243296000000",
    "number": "1811062169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3590 OLD MILTON PKWY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054465",
            "telephone_number": "770-521-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3590 OLD MILTON PKWY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054465",
            "telephone_number": "770-521-1978",
            "fax_number": "770-521-9936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGGAN",
        "first_name": "MANOJ",
        "name_prefix": "Dr.",
        "credential": "DDS, DAAPM, FICCMO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2009-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "11376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Alexis Maddox
• Madison Longchamp LLC (Heal and Grow Therapy Center of Atlanta)
• Ndidi Eugene Madu, D.O.
• Magellan Healthcare Services
• Veronica Magembe
• William Clark Maguire, RPH
• Shreya Chalam Mahadevan, M.D.
• Mahantkeshavjivandas LLC
• Dominique Maharath, PT, DPT
• Mahavir Health Services, LLC

• Dentist in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.