Active NPI
David A. Skoglund, DMD
- Pediatric Dentistry
- Dacula, GA
National Provider Identifier
1902933161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DN012873
- Practice address
- 2119 Hamilton Creek Pkwy
Suite 200
Dacula, GA 30019-3293 - Phone
- (770) 614-7011
- Fax
- (678) 714-8388
- NPI assigned
- Feb 27, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DN012873 | GA | Primary |
Addresses
Primary practice location
2119 Hamilton Creek Pkwy
Suite 200
Dacula, GA 30019-3293
Mailing address
3300 Mill Valley Dr
Dacula, GA 30019-1298
Phone (770) 945-5080
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN012873 | GA | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Dentistry at Hamilton Mill | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatric Dentistry
- Dacula, GA
- NPI 1437283025
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372723200000",
"number": "1902933161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 MILL VALLEY DR",
"city": "DACULA",
"state": "GA",
"postal_code": "300191298",
"telephone_number": "770-945-5080",
"fax_number": "678-714-8388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2119 HAMILTON CREEK PKWY",
"address_2": "SUITE 200",
"city": "DACULA",
"state": "GA",
"postal_code": "300193293",
"telephone_number": "770-614-7011",
"fax_number": "678-714-8388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKOGLUND",
"first_name": "DAVID",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-27",
"last_updated": "2013-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "GA",
"license": "DN012873",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dacula, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.