NPIMap

Organization Active NPI

Charles H Dodge DMD PC

  • General Practice Dentistry
  • Johns Creek, GA
National Provider Identifier
1962117804
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CHARLES H DODGE DMD PC
Doing business as
Charles H Dodge DMD PC
Practice address
9570 Nesbit Ferry Rd Ste 103
Johns Creek, GA 30022-6859
Phone
(770) 992-0502
NPI assigned
Jan 16, 2023
Last updated
Jan 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2023

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

Authorized official

Name
Dr. Charles H Dodge III, DMDNPI 1801976485
Title
President/Dentist
Phone
(770) 992-0502

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

9570 Nesbit Ferry Rd Ste 103
Johns Creek, GA 30022-6859

Mailing address

9570 Nesbit Ferry Rd Ste 103
Johns Creek, GA 30022-6859
Phone (770) 992-0502

Other names 1

  • Charles H Dodge DMD PC Doing business as

National Provider Directory

National Provider Directory

Locations

9570 Nesbit Ferry Rd
Ste 103
Johns Creek, GA 30022
Phone (770) 992-0502

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673827200000",
    "number": "1962117804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9570 NESBIT FERRY RD STE 103",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300226859",
            "telephone_number": "770-992-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9570 NESBIT FERRY RD STE 103",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300226859",
            "telephone_number": "770-992-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES H DODGE DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-16",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-11",
        "status": "A",
        "authorized_official_last_name": "DODGE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT/DENTIST",
        "authorized_official_telephone_number": "770-992-0502",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charles H Dodge DMD PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johns Creek, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; 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.