Page P Barden, D.D.S.

Key facts

NPI

1932115102

Entity type

Individual (NPI type 1)

Primary specialty

Periodontics 1223P0300X

License

DN010757 (GA)

Practice address

1024 Market Place Blvd
Cumming, GA 30041-7921

Phone

(770) 844-6771

Fax

(770) 844-6686

NPI assigned

Jul 31, 2006

Sex

Male

Sole proprietor

No

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.

• Wranglehurst, P.C. Dental Clinic/Center · Norcross, GA · NPI 1114145158
  NPD (past) Authorized official
• Wranglehurst, P.C. Periodontics · Norcross, GA · NPI 1790196467
  NPD (past) Authorized official PERIODONTICS

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

HHS exclusion list flag

The National Provider Directory flags this NPI as appearing on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

Practice roles

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 4, 2015.

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1932115102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4947 FAIRHAVEN WAY NE",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300756110",
            "telephone_number": "404-272-2512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 MARKET PLACE BLVD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417921",
            "telephone_number": "770-844-6771",
            "fax_number": "770-844-6686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARDEN",
        "first_name": "PAGE",
        "middle_name": "P",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "GA",
            "license": "DN010757",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN010757",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN010757",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00882934D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Cumming, GA · Periodontics in Georgia