Individual provider Active NPI

Olivia Jo Merandi, DDS

  • Dentist
  • Cartersville, GA
National Provider Identifier
1922593763
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN015727 Issued in GA
Practice address
791 Joe Frank Harris Pkwy SE Ste B
Cartersville, GA 30120-2430
Phone
(470) 274-2828
Fax
(470) 274-2822
NPI assigned
Jun 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 33981 TX
Dentist 122300000X DN015727 GA Primary

Addresses

Primary practice location

791 Joe Frank Harris Pkwy SE Ste B
Cartersville, GA 30120-2430

Mailing address

791 Joe Frank Harris Pkwy SE Ste B
Cartersville, GA 30120-2430
Phone (470) 274-2828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211101001124 GA Order and Referring Only - DentistPractitioner - Dentist 4981092533

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33981TXMDPharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Downeast Smile Company General Practice CurrentSince Jul 1, 2022 Accepting new patients
Downeast Smile Company LLC General Practice CurrentSince Jun 1, 2022 Accepting new patients

Locations

791 Joe Frank Harris Pkwy SE
Ste B
Cartersville, GA 30120
Phone (470) 274-2828

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1922593763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "791 JOE FRANK HARRIS PKWY SE STE B",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202430",
            "telephone_number": "470-274-2828",
            "fax_number": "470-274-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "791 JOE FRANK HARRIS PKWY SE STE B",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202430",
            "telephone_number": "470-274-2828",
            "fax_number": "470-274-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERANDI",
        "first_name": "OLIVIA",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "33981",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN015727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

Verify at the official NPI Registry.