Individual provider Active NPI

Mtizi Dee Morris, D.M.D.

  • Dentist
  • Roswell, GA
National Provider Identifier
1922110428
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
GA 011187 Issued in GA
Practice address
1297 Hembree Rd
Ste 202
Roswell, GA 30076-5721
Phone
(770) 475-6767
Fax
(770) 475-0493
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X GA 011187 GA Primary

Addresses

Primary practice location

1297 Hembree Rd
Ste 202
Roswell, GA 30076-5721

Mailing address

1297 Hembree Rd
Ste 202
Roswell, GA 30076
Phone (770) 475-6767

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
GA 011187GAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1922110428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1297 HEMBREE RD",
            "address_2": "STE 202",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "30076",
            "telephone_number": "770-475-6767",
            "fax_number": "770-485-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1297 HEMBREE RD",
            "address_2": "STE 202",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765721",
            "telephone_number": "770-475-6767",
            "fax_number": "770-475-0493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "MTIZI",
        "middle_name": "DEE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "GA 011187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.