Individual provider Active NPI

Donald Robert Correll, DDS

  • General Practice Dentistry
  • Decatur, GA
National Provider Identifier
1861599425
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
GA7828 Issued in GA
Practice address
5040 Snapfinger Woods Dr
Suite 203
Decatur, GA 30035-4020
Phone
(770) 981-9700
Fax
(770) 323-6226
NPI assigned
Sep 17, 2006
Sex
Male
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
General Practice Dentistry 1223G0001X GA7828 GA Primary

Addresses

Primary practice location

5040 Snapfinger Woods Dr
Suite 203
Decatur, GA 30035-4020

Mailing address

5040 Snapfinger Woods Dr
Suite 203
Decatur, GA 30035-4020
Phone (770) 981-9700

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
I20150713001799 GA Order and Referring Only - DentistPractitioner - Dentist 2668785163

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
GA7828GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Smith and Correll DDS PC General Practice Past Accepting new patients
East Atlanta Dental PastSince Jun 26, 2022 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861599425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5040 SNAPFINGER WOODS DR",
            "address_2": "SUITE 203",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300354020",
            "telephone_number": "770-981-9700",
            "fax_number": "770-323-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5040 SNAPFINGER WOODS DR",
            "address_2": "SUITE 203",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300354020",
            "telephone_number": "770-981-9700",
            "fax_number": "770-323-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRELL",
        "first_name": "DONALD",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "GA7828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.