Demetris Estella Rush, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN012595 Issued in GA

Practice address

3820 Pleasant Hill Rd
Suite 1
Duluth, GA 30096-1429

Phone

(770) 497-0110

Fax

(770) 497-0580

NPI assigned

Jun 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Peachtree Children'S Dentistry

  • Pediatric Dentistry
  • Duluth, GA
  • NPI 1770754772
  NPD (past)
• Peachtree Children'S Dentistry Snellville

  • Pediatric Dentistry
  • Snellville, GA
  • NPI 1750434643
  NPD (past)

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366070400000",
    "number": "1841237476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 SCENIC HWY N STE 510",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300785635",
            "telephone_number": "770-979-6400",
            "fax_number": "770-979-7465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 PLEASANT HILL RD",
            "address_2": "SUITE 1",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300961429",
            "telephone_number": "770-497-0110",
            "fax_number": "770-497-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSH",
        "first_name": "DEMETRIS",
        "middle_name": "ESTELLA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2013-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN012595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000947944B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000947944C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaydine Royes
• Ruby & Pearl Wellness
• Noelle E Ruddock-Solomon, M.D.
• Oriana La'Niece Ruiz-Suarez
• Alexandra Leigh Ruiz
• Robert Randall Rusher, MD
• Gabriela Yalitza Ruvalcaba
• RV Patel, LLC.
• RX Universal LLC
• RX Universal LLC

• Pediatric Dentistry in Duluth, GA
• Providers in Duluth, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2013; 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.