Organization Active NPI

Ga Oral and Facial Surgery LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Dawsonville, GA
National Provider Identifier
1881484723
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
GA ORAL AND FACIAL SURGERY LLC
Practice address
200 Dawson Commons Cir Ste 210
Dawsonville, GA 30534-6265
Phone
(706) 265-1700
NPI assigned
May 12, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Authorized official

Name
Jackie Holloway
Title
Director of RCM
Phone
(854) 200-7970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

200 Dawson Commons Cir Ste 210
Dawsonville, GA 30534-6265

Mailing address

3700 Ingleside Blvd
Ladson, SC 29456-4141

Other names 1

  • Dawson Oral and Maxillofacial Surgery Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1747008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747008000000",
    "number": "1881484723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 INGLESIDE BLVD",
            "city": "LADSON",
            "state": "SC",
            "postal_code": "294564141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DAWSON COMMONS CIR STE 210",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305346265",
            "telephone_number": "706-265-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GA ORAL AND FACIAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-12",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A",
        "authorized_official_last_name": "HOLLOWAY",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "DIRECTOR OF RCM",
        "authorized_official_telephone_number": "854-200-7970"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dawson Oral and Maxillofacial Surgery",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Dawsonville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.