Olexa Podebryi, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN014749 Issued in GA

Practice address

2120 W Spring St Ste 1100
Monroe, GA 30655-3900

Phone

(770) 266-7188

NPI assigned

Aug 10, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Alex Podebryi Professional name

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Monroe Family & Cosmetic Dentistry

  • General Practice Dentistry
  • Monroe, GA
  • NPI 1902264252
  NPD (past)
• Monroe Family and Cosmetic Dentistry

  • General Practice Dentistry
  • Monroe, GA
  • NPI 1518102961
  NPD (past)

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

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454371200000",
    "number": "1871808378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 W SPRING ST STE 1100",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306553900",
            "telephone_number": "770-266-7188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 W SPRING ST STE 1100",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306553900",
            "telephone_number": "770-266-7188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODEBRYI",
        "first_name": "OLEXA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-10",
        "last_updated": "2016-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "50055056",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN014749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEX",
            "last_name": "PODEBRYI",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Joaslanda Pierre, BSN, RN
• Misty Jovon Pinson, LCSW
• Sara Fitzpatrick Pittman, RPH, PHARMD
• Michelle Lynn Plaster, M.D.
• Luis Pluguez, PA
• Abigail Porter
• Premier Anesthesia Associates
• Premier Kids Care, Inc. (Premier Care)
• Premier Kids Care, Inc. (Premier Care)
• Premise Health of Georgia Medical PC (Walton EMC - Monroe)

• Dentist in Monroe, GA
• Providers in Monroe, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; 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.