Peachtree Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11376 Issued in GA

Legal business name

PEACHTREE DENTAL GROUP

Practice address

3590 Old Milton Pkwy
Alpharetta, GA 30005-4465

Phone

(770) 521-1978

Fax

(770) 521-9936

NPI assigned

May 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Manoj Maggan, DDSNPI 1811062169

Title

President

Phone

(770) 521-1978

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Manoj Maggan, DDS, DAAPM, FICCMO

  • Dentist
  • Alpharetta, GA
  • NPI 1811062169
  NPD (past) Authorized official

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871703553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3590 OLD MILTON PARKWAY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "30005",
            "telephone_number": "770-521-1978",
            "fax_number": "770-521-9936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3590 OLD MILTON PKWY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054465",
            "telephone_number": "770-521-1978",
            "fax_number": "770-521-9936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAGGAN",
        "authorized_official_first_name": "MANOJ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-521-1978",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "11376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peace of Mind Psychological Service, LLC
• Peaceful Horizons Counseling, LLC
• Peach Medical Systems Associates LLC
• Peach Psychiatric Systems Associates LLC
• Peach State Medical Supplies, LLC
• Peachtree Eye Associates P C
• Peachtree Medical Group LLC
• Peachtree Orthopaedic Clinic
• Peachtree Psychotherapy, P.C.
• Jere Dillon Peak Jr., CRNA

• General Practice Dentistry in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.