Individual provider Active NPI

Stephanie Ann Jaipaul, DMD

  • General Practice Dentistry
  • Austell, GA
National Provider Identifier
1831885466
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN122712 Issued in GA
Practice address
3845 Medical Park Dr
Austell, GA 30106-1109
Phone
(770) 944-3737
NPI assigned
Apr 17, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN122712 GA Primary

Addresses

Primary practice location

3845 Medical Park Dr
Austell, GA 30106-1109

Mailing address

1000 Park Ave NE Unit 810
Atlanta, GA 30326-3449
Phone (917) 880-4320

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
DN122712GAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1831885466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 PARK AVE NE UNIT 810",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303263449",
            "telephone_number": "917-880-4320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3845 MEDICAL PARK DR",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061109",
            "telephone_number": "770-944-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIPAUL",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-17",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN122712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.