Individual provider Active NPI

Suaddah Irvin, DMD

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1871340935
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN123690 Issued in GA
Practice address
1015 Donald Lee Hollowell Pkwy NW
Atlanta, GA 30318-6653
Phone
(404) 523-6571
NPI assigned
May 6, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X DN123690 GA Primary

Addresses

Primary practice location

1015 Donald Lee Hollowell Pkwy NW
Atlanta, GA 30318-6653

Mailing address

170 Northside Dr SW Apt 202
Atlanta, GA 30313-1391
Phone (618) 406-2986

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
DN123690GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Hope First Investments CurrentSince May 12, 2024 Accepting new patients
The Good Samaritan Health Center, Inc. CurrentSince May 12, 2024 Accepting new patients

Locations

1015 Donald Lee Hollowell Pkwy NW
Atlanta, GA 30318
Phone (404) 523-6571

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": "1714953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1871340935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 NORTHSIDE DR SW APT 202",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303131391",
            "telephone_number": "618-406-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 DONALD LEE HOLLOWELL PKWY NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303186653",
            "telephone_number": "404-523-6571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRVIN",
        "first_name": "SUADDAH",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-06",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN123690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.