James Reid Roberts III, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN012947 Issued in GA

Practice address

1125 Commerce Dr Ste 100
Suite a
Peachtree City, GA 30269-3575

Phone

(770) 486-8516

Fax

(770) 818-5547

NPI assigned

Aug 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1922112606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 COMMERCE DR STE 100",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302693575",
            "telephone_number": "770-486-8516",
            "fax_number": "770-818-5547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 COMMERCE DR STE 100",
            "address_2": "SUITE A",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302693575",
            "telephone_number": "770-486-8516",
            "fax_number": "770-818-5547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JAMES",
        "middle_name": "REID",
        "name_suffix": "III",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "679226597B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "679226597C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "679226597A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Richart
• Deana Riley, L.P.C., C.P.C.S.
• Rise Beyond Words LLC
• Robert S.Brooks DDS & Timothy J. Kaiglerdmd
• Beverly Roberts, D.M.D.
• Jerry M. Roberts, M.D.
• Kathleen L Robinson, D.M.D.
• Mary Robson
• Halie Morgan Rodino, DNP, APRN, FNP-BC
• Frank William Rogers, DMD

• General Practice Dentistry in Peachtree City, GA
• Providers in Peachtree City, 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 26, 2015; 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.