Individual provider Active NPI

Marty Mazzawi, D.D.S.

  • General Practice Dentistry
  • Snellville, GA
National Provider Identifier
1972596492
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN012731 Issued in GA
Practice address
2268 E Main St
Snellville, GA 30078-3498
Phone
(770) 972-4436
Fax
(770) 985-8810
NPI assigned
Aug 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN012731 GA Primary

Addresses

Primary practice location

2268 E Main St
Snellville, GA 30078-3498

Mailing address

PO Box 365
Snellville, GA 30078-0365
Phone (770) 972-4436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN012731GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mazzawi Family Dentistry, P.C. General Practice Past Accepting new patients

Organizations & group practices 1

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1972596492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 365",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300780365",
            "telephone_number": "770-972-4436",
            "fax_number": "770-985-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2268 E MAIN ST",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300783498",
            "telephone_number": "770-972-4436",
            "fax_number": "770-985-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZAWI",
        "first_name": "MARTY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.