Mary Wolfe Doornbos, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN013886 Issued in GA

Practice address

135 Johnson Ferry Rd
Suite 2210
Marietta, GA 30068-4942

Phone

(404) 353-6651

NPI assigned

Jun 17, 2009

Last updated

Jan 24, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Mary Addison Wolfe Former name

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": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1952538928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2227 AUSTIN LAKE DR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300823381",
            "telephone_number": "706-518-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 JOHNSON FERRY RD",
            "address_2": "SUITE 2210",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684942",
            "telephone_number": "404-353-6651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOORNBOS",
        "first_name": "MARY",
        "middle_name": "WOLFE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-17",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "8938",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013886",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN013886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "WOLFE",
            "middle_name": "ADDISON",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Yanique S Donaldson, FNP
• Yuliyan Donchev, MD
• Charles Dong, DMD
• John William Donnelly, M.D.
• Lisa Donohue, OTR/L
• Kevin James Doran, DDS
• Barbara Sainte Dorcely, REGISTERED NURSE
• Dorfzaun Eye Group,L.L.C.
• Sander Sol Dorfzaun, O.D.
• John Marvin Doris, D.D.S.

• Pediatric Dentistry in Marietta, GA
• Providers in Marietta, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2014; 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.