Michael Mina Guirguis, DDS

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

DN015285 Issued in GA

Practice address

2600 Martin Luther King Jr Dr SW
Atlanta, GA 30311-1636

Phone

(404) 564-7749

NPI assigned

Jun 8, 2013

Sex

Male

Sole proprietor

Yes

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 MD

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

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

{
    "created_epoch": "1370649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490832000000",
    "number": "1841638152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 MARTIN LUTHER KING JR DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303111636",
            "telephone_number": "404-564-7749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 MARTIN LUTHER KING JR DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303111636",
            "telephone_number": "404-564-7749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUIRGUIS",
        "first_name": "MICHAEL",
        "middle_name": "MINA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-08",
        "last_updated": "2017-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "GA",
            "license": "DN015285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Didier Guillaume, DMD
• Jose Enrique Guillen Jr., PA-C
• Nia Jordan Guine-Herndon
• Ana Isabel Guinea-Martin, MD
• Guinning Therapy, LLC
• Angela Elizabeth Gulledge
• Caleb Michael Gulledge, MD
• Samuel T. Gulley, DDS
• Susan Elizabeth Gulley, LPC
• Tanesha Gulley, NP

• Public Health Dentistry in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Public Health Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; 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.